r. 


I^EKEEEEE^^I^I^IXIdEBEEEEtLs: 


Presented  in  honor  of 


|  Solon  Richard  Boynton  Sr.,  M.  D. 


COLLEGE    OF    OSTEOPATHIC     PHYSICIANS 
AND  SURGEONS  •    LOS  ANGELES,  CALIFORNIA 


H 


WILLIAM  RADDE, 

IMPORTER,  BOOKSELLER,  AND  PUBLISHER, 

322  BROADWAY,  NEW-YORK. 

IMPORTATION  OF  BOOKS,  ENGLISH  AND  FOREIGN, 

FOR    COLLEGES,    PUBLIC    AND    PRIVATE    LIBRARIES,   ETC.,  ETC. 

SINGLE  BOOKS  IMPORTED  TO  ORDER. 

Orders  forwarded  by  every  Steamer,  and  also  by  the  Liverpool  Packets, 
and  answered  promptly  by  the  return  of  the  first  steamer  after  the  receipt, 
if  desired. 

W.  R.  would  invite  attention  to  his  facilities  for  procuring  English  and 
Foreign  Books  for  Colleges,  Public  and  Private  Libraries,  Booksellers, 
and  the  Public  generally,  on  at  least  as  good  terms,  and  with  greater  dis- 
patch than  they  have  ever  before  been  imported  into  this  country  by  any 
other  establishment. 

HOMOEOPATHIC   MEDICINES. 

WM.  RADDE,  322  Broadway,  New- York,  respectfully  informs  the  Homoeo- 
pathic Physicians,  and  the  friends  of  the  System,  that  he  is  the  sole  Agent 
for  the  Leipzig  Central  Homoeopathic  Pharmacy,  and  that  he  has  always  on 
hand  a  good  assortment  of  the  best  Homoeopathic  Medicines,  in  complete 
sets  or  by  single  vials,  in  Tinctures,  Dilutions  and  Triturations  ;  also  Pocket 
Cases  of  Medicines;  Physicians''  and  Family  Medicine  Chests  to  Laurie's  Do- 
mestic (60  ReiUdies)— EPP'S  (57  Remedies)— BERING'S  (58  Remedies). 


POCKET  CASES  with  60  Vials  of  Tinctures  and  Triturations  —Cases  from 
200  to  400  Vials  with  low  and  high  dilutions  of  medicated  pellets. — Cases 
from  50  to  80  Vials  of  low  and  high  dilutions,  &c.,  &c.  Homoeopathic 
Chocolate,  Refined  Sugar  of  Milk,  pure  Globules,  &c.,  Arnica  Tincture, 
the  best  specific  remedy  for  bruises,  sprains,  wounds,  &c.,  Urtica  Urens  for 
Burns,  as  well  as  Books,  Pamphlets,  and  Standard  Works  on  the  System, 
in  the  English,  French,  and  German  languages. 

HOMOEOPATHIC   BOOKS. 

THE  HOMOEOPATHIC  EXAMINER  (Second  Volume,  New  Series) 
was  issued  on  the  loth  day  of  August,  1846,  and  thereafter  on  the  first  of 
each  month.  Price,  §'5  in  advance,  or  50  cents  each  number. 

Forty-eight  pages  of  every  number  will  be  constantly  devoted  to  the 
translation  of  some  standard  work  on  Homoeopathy.  In  the  1st  vol.  we  have 
given  Ruckert's  Therapeutics,  which  is  completed  in  ten  numbers,  and  have 
now  concluded  Stapf's  Additions  to  the  Materia  Medica.  Bonninghausen's 
Therapeutic  Pocket-Book,  which  has  been  commenced  in  the  last  number, 
will  be  continued  in  the  succeeding  numbers  of  the  Examiner.  2  volumes, 
well  bound,  §6  00. 

The  Journal  will  hereafter  be  edited  by  Drs.  Gray  and  Hempel. 

WM.  RADDE,  Publisher  and  Proprietor. 


2  Homoeopathic  Books. 

In  Press, 

A  TRANSLATION  OF  JAHR'S  NEW  MANUAL, 

WHICH    HAS    RECENTLY    BEEN    PUBLISHED    IN    GERMANY, 
UNDER   THE    NAME    OF 

S  YMP  T  0  ME  N-C  0  DE  X. 

.  (DIGEST  OF  SYMPTOMS.) 

This  work  is  intended  to  facilitate  a  comparison  of  the  parallel  symptoms 
of  the  various  homoeopathic  agents,  thereby  enabling  the  practitioner  to  dis- 
cover the  characteristic  symptoms  of  each  drug,  and  to  determine  with  ease 
and  correctness  what  remedy  is  most  homoeopathic  to  the  existing  group  of 
symptoms. 

Translated  by  C.  J.  HEMPEL,  M  D.,  of  New-York,  and  revised  by  JOHN  F. 
GRAY,  M.D.,  of  New- York,  with  a  Preface  by  CONSTANTINE  HERING,  M.D., 
of  Philadelphia. 

This  new  Manual  is  distinguished  from  the  old  by  many  important  and  es- 
sential advantages.  It  is  much  more  complete  than  the  former  editions  of 
JAHR,  embracing  nearly  three  times  the  amount  of  matter  contained  in  the 
old  JAHR,  and  furnishing,  moreover,  the  pathogenetic  symptoms  of  several 
entirely  new  remedies,  by  distinguished  provers.  There  are  several  thou- 
sand new  Asterisks  in  the  present  Manual,  and  the  number  of  empirical 
symptoms,  which  JAHR  has  been  in  the  habit  of  designating  by  a  cypher,  is 
likewise  considerably  increased.  The  expression  of  the  symptoms,  as  re- 
corded in  the  Materia  Medica  Pura,  and  in  the  isolated  provings  of  recent 
observers,  has  been  retained,  and  only  unnecessary  repetitions  have  been 
avoided. 

The  editors  have  pledges  of  valuable  assistance  from  Dr.  Constantine 
Hering,  of  Philadelphia ;  Drs.  A.  Gerald  Hull  and  James  M.  Quin,  of  New- 
York;  Jacob  Jeanes,  M.D.,  C.  Neidhard,  M.D.,  W.  Williamson,  M.D  ,  and 
James  Kitchen,  of  Philadelphia. 

The  editors  pledge  themselves  for  the  correctness  of  the  translation,  and 
invite  the  profession  to  subscribe  to  the  present  work  with  |^e  fullest  and 
most  implicit  confidence. 

Subscribers  will  be  allowed  a  discount  of  10  per  cent,  on  the  future  retail 
price,  which  will  be  extremely  moderate,  notwithstanding  the  elegance  and 
care  with  which  the  work  will  be  got  up. 

Each  number  contains  96  octavo  pages.     Price  50  cents. 

Subscribers,  and  all  those  who  are  friendly  to  our  cause,  are  respectfully 
requested  to  distribute  our  Prospectusses  among  all  those  who  may  be  in- 
terested in  the  publication  of  our  work. 

Every  number  or  volume  is  to  be  paid  for  on  delivery. 

Names  of  subscribers  may  be  sent  in  to 

WILLIAM  RADDE,  Publisher,  322  Broadway,  New- York. 
C.  L.  RADEMACHER,  39  North  Fourth-street,  Philadelphia. 
OTIS  CLAPP,  12  School-street,  Boston,  Mass. 

George  Jones,  M.D.,  Albany,  N.  Y. ;  Myers  &.  Wynkoop,  Syracuse,  N.  Y. ;  J.  C.  Der- 
by &  Co.,  Auburn,  N.  Y.;  R.  G.  &  P.  S.  Wynkoop,  Auburn,  N.  Y. ;  Alduifc  Mark- 
ham,  Auburn,  N.  Y. ,  P.  S.  &  R.  G.  Wynkoop,  Hudson,  N.  Y. ;  Bennett,  Backus  & 
Hawley,  Utica,  N.  Y. ;  J.  M.  Page,  Geneva,  N.  Y. ;  Samuel  Hamilton.  Rochester,  N.  Y.; 
M.  M.  Matthews,  M.D.,  Rochester,  N.  Y. ;  S.  (,'.  Griggs,  Hamilton,  N.  Y. :  Dr.  P.  W. 
Gray.  Buffalo,  N.  Y. ;  John  Paine,  M.D.,  Belfast  Maine ;  C.  Burnett,  Providence,  R.  I. ; 
F.  W.  Weiss  &.  Roeder,  Cleveland,  Ohio;  Morrill  &  Cate,  Columbus,  Ohio:  Derby, 
Bradley  &  Co.,  Cincinnati,  Ohio;  G.  S.  Peters,  Harrisburg,  Pa.;  J.  G.  Backofen,  Pitts- 
bur;:.  Pa.;  F.  R.  Mr.Manus,  M.D.,  Baltimore,  Md. ;  W.  Adams,  Washington,  D.  C.; 
Belding  &  Chase,  Wheeling,  Va.  ;  Dr.  D.  S.  Smith,  Chicago,  III.;  Dr.  Pitney,  Chicago, 

111.;  Drs  Whealon  &  Ellis,  Detroit,  Mich.;  Seymour,  Bookseller,  Detroit,  Mich.; 

James  Maxwell,  Louisville,  Ky. ;  Bruno  &  Virgins,  Macon,  Geo. ;  Bruno  &  Virgins, 
Columbus,  Geo.;  Dr.  Tafl,  New  Orleans,  La.;  C.  F.  Franksen  &  Wesselhteft,  St. 
Louis,  Missouri ;  Morgan  &  Cracker,  Nashville,  Tennessee;  Young  &  Smith,  Colum- 
bus, Mississippi ;  Win.  Lytnan  '&  Co.,  Montreal,  Canada. 


Homceopathic  Books.  3 

JAHR,  G.  H.  G.,  M.D.  SHORT  ELEMENTARY  TREATISE  UPON 
HOMCEOPATHIA  AND  THE  MANNER  OF  ITS  PRACTICE;  with 
some  of  the  most  important  effects  of  ten  of  the  principal  Homoeopathic 
remedies,  for  the  use  of  all  honest  men  who  desire  to  convince  themselves 
by  experiment,  of  the  truth  of  the  doctrine.  Second  French  edition,  cor- 
rected and  enlarged.  Translated  hy  Edward  Bayard,  M.D.  Bound,  37J  cts. 

JAHR'S  NEW  MANUAL  OF  HOMCEOPATHIC  PRACTICE.  Edited, 
with  Annotations,  by  A.  GERALD  HUT.L,  M.D.  From  the  third  Paris  edition. 
2  vols.,  bound,  $6. 

HAHNEMANN,  Dr.  S.  THE  CHRONIC  DISEASES,  THEIR  SPE- 
CIFIC NATURE  AND  HOMCEOPATHIC  TREATMENT.  Translated 
and  edited  by  Charles  J.  Hempel,  M.D.,  with  a  Preface,  by  Constantine 
Hering,  M.D.,  Philadelphia.  8vo.  5  volumes.  Bound.  1845.  $7. 

HEMPEL'S    HOMCEOPATHIC     DOMESTIC    PHYSICIAN.      1846. 

Bound,  50  cts. 

BCENNINGHAUSEN'S  ESSAY  ON  THE  HOMCEOPATHIC  TREAT- 
MENT OF  INTERMITTENT  FEVERS.  Translated  and  edited  by 
Charles  Julius  Hempel,  M.D.  1845.  38  cts. 

A  TREATISE  ON  THE  USE  OF  ARNICA,  in  cases  of  Contusions, 
Wounds,  Strains,  Sprains,  Lacerations  of  the  Solids,  Concussions,  Paralysis, 
Rheumatism,  Soreness  of  the  Nipples,  etc.,  etc.,  with  a  number  of  cases  il- 
lustrative of  the  use  of  that  drug.  By  Charles  Julius  Hempel,  M.D.  1845. 

18J  cts. 

HAHNEMANN,  Dr.  S.  MATERIA  MEDICA  PURA.  Translated  and 
edited  by  Charles  Julius  Hempel,  M.D.  4  vols.  1846.  $6. 

HOMCEOPATHIC  COOKERY.  Second  edition,  with  additions,  by  the 
Lady  of  an  American  Homffiopathic  Physician.  Designed  chiefly  for  the 
use  of  such  persons  as  are  under  homoeopathic  treatment.  50  cts. 

RUECKERT'S  THERAPEUTICS;  or,  Successful  Homoeopathic  Cures, 
collected  from  the  best  Homoeopathic  Periodicals.  1  large  8vo.  vol.,  bound, 
$350. 

THE  HOMCEOPATHIC  EXAMINER.  Dy  Drs.  Gray  and  Hempel. 
Vol.  I.,  New  Series.  1846.  Bound  in  two  volumes.  $6  00. 

TRANSACTIONS  OF  THE  AMERICAN  INSTITUTE  OF  HOMCE- 
OPATHY.  1846.  Bound,  $1 50. 

WM.  HENDERSON,  M.D.  HOMCEOPATHIC  PRACTICE.  1846. 
60  cts. 

FORBES,  M.D.  HOMCEOPATHY,  ALLOPATHY,  AND  YOUNG 
PHYSIC.  1846.  19  cts. 

WM.   HENDERSON,  M.D.     LETTER  TO  JOHN  FORBES.      1846. 
19  cts. 
ft^-  The  above  three  books,  bound  in  one  volume,  $1. 


4  Homoeopathic  Books. 

C.  HERING,  M.D.  DOMESTIC  PHYSICIAN.  Third  American, 
with  additions  from  the  fifth  German  edition.  1845.  Bound,  $2. 

C.  NEIDHARD,  M.D.  AN  ANSWER  TO  THE  HOMOEOPATHIC 
DELUSIONS  OF  DR.  O.  W.  HOLMES.  18*  cts. 

HARTMANN,  DR.  F.  PRACTICAL  OBSERVATIONS  ON  SOME 
OF  THE  CHIEF  HOMOEOPATHIC  REMEDIES.  Translated  from  the 
German,  by  A.  H.  OKIE,  M.D.  First  Series.  Bound,  $1. 

The  second  and  last  Series.    Bound,  $1. 

EPPS,  DR.  J.  DOMESTIC  HOMOEOPATHY;  or,  Rules  for  the  Do- 
mestic Treatment  of  the  Maladies  of  Infants,  Children,  and  Adults,  etc. 
Second  American  from  the  fourth  London  edition.  1845.  Bound,  75  cts. 

J.  JEANES,  M.D.    HOMOEOPATHIC  PRACTICE  OF  MEDICINE. 

•f. 

A.  G.  HULL,  M.D.  THE  DOMESTIC  TREATMENT  OF  THE 
CONVULSIONS  OF  INFANTS.  25  cts. 

DR.  CURIE.  ANNALS  OF  THE  LONDON  HOMOEOPATHIC  MED- 
ICAL INSTITUTION.  Reports  of  Cases.  Nos.  1-21.  1842.  $4. 

DEFENCE  OF  HAHNEMANN  AND  HIS  DOCTRINES,  INCLUD- 
ING AN  EXPOSURE  OF  DR.  ALEX.  WOOD'S  "  HOMOEOPATHY 
UNMASKED."  London,  1844.  50  cts. 

ORGANON  OF  HOMOEOPATHIC  MEDICINE.  By  SAMUEL  HAHXE- 
MANN.  Second  American  from  the  British  translation  of  the  fourth  German 
edition.  With  improvements  and  additions  from  the  fifth,  hy  the  North 
American  Academy  of  the  Homoeopathic  Healing  Art.  New- York,  1843. 
Price,  bound,  $1. 

LAURIE,  DR.  J.  HOMOEOPATHIC  DOMESTIC  MEDICINE,  with 
the  Treatment  and  Diseases  of  Females,  Infants,  Children,  and  Adults. 
Third  American  edition,  with  additions  by  A.  G.  Hull,  M.D.  1846.  Bound, 
$125. 

RUOFF'S  REPERTORY  OF  HOMOEOPATHIC  MEDICINE,  nosolog- 
ically  arranged.  Translated  from  the  German,  by  A.  H.  Okie,  M.D.,  trans- 
lator of  Hartmann's  Remedies.  Second  American  edition,  with  additions 
and  improvements,  by  G.  HUMPHREY,  M.D.,  etc.  1844.  Bound,  $1  50. 

THE  HOMOEOPATHIC  EXAMINER,  by  A.  G.  HULL,  M.D.  3  vols., 
1840  and  1841,  and  1842-1845.  $15. 

A  POPULAR  VIEW  OF  HOMOEOPATHY,  by  Rev.  THOMAS  R.  EV- 
EREST, Rector  of  Wickwar.  With  annotations,  and  a  brief  survey  of  the 
state  and  progress  of  Homoeopathia  in  Europe,  by  A.  GERALD  HULL,  M.D. 
From  the  second  London  edition.  Bound.  Price  $1. 

THE  FAMILY  GUIDE  TO  THE  ADMINISTRATION  OF  HOMOE- 
OPATHIC REMEDIES.  Third  edition,  after  the  second  London  edition, 
with  additions.  Price  25  cts. 


Hojnceopathic  Books.  5 

AN  EPITOME  OF  HOMCEOPATHIC  PRACTICE.  Compiled  chiefly 
from  Jahr,  Rueckert,  Beauvais,  BoBnninghausen,  etc.  By  J.  T.  CURTIS, 
M.D.,  and  J.  LILLIE,  M.D.  1843.  Bound,  87i  cts. 

JAHR'S  PHARMACOPOEIA,  and  Posology  of  the  Preparation  of  Homoe- 
opathic Medicines,  and  the  Administration  of  the  Dose.  Translated  by  F. 
Kitchen.  $2. 

THE  PRACTICAL  ADVANTAGES  OF  HOMOEOPATHY,  illustrated 
by  numerous  cases.  Dedicated,  by  permission,  to  Her  Majesty  Queen  Ad- 
elaide. By  H.  DUNSFORD,  M.D.  $1. 

THE  BRITISH  JOURNAL  OF  HOMOEOPATHY.  Edited  by  J.  J. 
DRYSDALE,  M.D.,  J.  R.  RUSSELL,  M.D.,  and  FRANCIS  BLACK,  M.D.  Lon- 
don. 1843-1845.  Nos.  1-15. 

JAHR'S  MANUAL  OF  HOMCEOPATHIC  MEDICINE.  Translated 
from  the  German.  With  an  introduction  and  some  additions,  by  C.  HERING, 
M.D.  1838.  Bound,  $2  50. 

F.  VANDERBURGH,  M.D.  AN  APPEAL  FOR  HOMOEOPATHY; 
jor,  Remarks  on  the  Decision  of  the  late  Judge  Cowan,  relative  to  the  legal 
rights  of  Homoeopathic  Physicians.  1844.  12J  cts. 

M.  CROSERIO,  M.D.,  ON  HOMCEOPATHIC  MEDICINE.  Illus- 
trating its  superiority  over  the  other  medical  doctrines,  with  an  account' 
of  the  regimen  to  be  followed  during  the  treatment  of  Homoeopathy. 
Translated  from  the  French.  25  cts. 

SHERRILL'S  MANUAL  OF  HOMCEOPATHY.    37*  cts. 

HYDRIATICS,  OR  MANUAL  OF  THE  WATER  CURE.— Especially 
as  practised  by  Vincent  Priessnitz,  in  Graffenberg ;  compiled  and  translated 
from  the  writings  of  Charles  Munde,  Dr.  Oertel,  Dr.  B.  Hirschel,  and  other 
eye-witnesses  and  practitioners. — Fourth  edition,  by  FRANCIS  GRAETER. 
Price  50  cents,  with  one  plate  or  six  engravings.  1844. 

ROKYTANSKY'S  PATHOLOGICAL  ANATOMY.  Translated  from 
the  German,  with  additions  on  Diagnosis,  from  Schonlein,  Skoda,  and  others, 
by  Dr.  JOHN  C.  Peters.  1844.  75  cts. 

Opinions  of  the.Press. — "  Dr.  Rokytansky's  book  is  no  more  than  it  pro- 
fesses to  be :  it  is  morbid  Anatomy  in  its  densest  and  most  compact  form, 
scarcely  ever  alleviated  by  histories,  cases,  or  hypotheses.  It  is  just  such  a 
work  as  might  be  expected  from  its  author,  who  is  said  to  have  written  in  it 
the  result  of  his  experience  gained  in  the  careful  examination  of  over  12,000 
bodies,  and  who  is  possessed  of  a  truly  marvellous  power  of  observing  and 
amassing  facts.  In  the  course  of  our  analysis  we  have  said  comparatively 
little  of  its  merits,  the  best  evidence  of  which  is  found  in  the  length  to  which 
our  abstracts  have  been  carried  without  passing"  beyond  the  bounds  of  what 
is  novel  or  important.  Nor  would  this  fault  have  been  committed  though 
much  more  had  been  borrowed,  for  no  modern  volume  on  morbid  Anatomy 
contains  half  so  many  genuine  facts  as  this;  it  is  alone  sufficient  to  place  its 
author  in  the  highest  rank  of  European  medical  observers." — British  and 
Foreign  Medical  Review,  January,  1843. 


6  Homoeopathic  Books. 

ENCHIRIDION  MEDICUM,  or  the  Practice  of  Medicine  ;  the  result  of 
fifty  years'  experience.  By  C.  W.  HUFELAND,  counsellor  of  state,  physician 
in  ordinary  of  the  late  King  of  Prussia,  professor  in  the  University  of  Berlin. 
From  the  sixth  German  edition.  Translated  by  C.  Bruchhausen,  M.D. ;  re- 
vised by  R.  Nelson,  M.D.  Second  American  edition.  1844.  Bound,  $2  50. 

Opinions. — The  following  lines  from  Dr.  Manley,  formerly  President  of  the 
Medical  Society  of  the  State  of  New- York,  contains  his  opinion  in  few  words 
of  the  merits  of  the  book  : 

I  am  happy  to  have  the  opportunity  of  recommending  to  the  medical  pro- 
fession the  Manual  of  the  Practice  of  Medicine,  by  Hufeland.  It  is  not  often 
that  books  of  this  character,  on  perusal,  make  good  the  claims  which  their 
titles  assume,  but  this  is  a  well-marked  exception :  its  descriptions  of  dis- 
eases, though  concise,  are  comprehensive ;  its  reasonings  just  and  philosophi- 
cal, and  its  practice,  as  a  consequence,  intelligible  and  rational.  The  character 
of  the  author,  and  his  experience  of  more  than  half  a  century,  together  with 
the  unexampled  popularity  of  the  work  in  its  original  language,  render  in  my 
opinion  all  individual  recommendation  superfluous.  I  hope  that  it  may  soon 
be  found  in  the  hands  of  every  medical  man,  whether  pupil  or  practitioner. 

JAMES  R.  MAULEY,  M.D. 

New- York,  September  7, 1842. 

Certificate  of  JOHN  F.  GRAY,  M.D.,  formerly  Resident  Physician  to  the 
New- York  Hospital,  Lecturer  on  the  Theory  and  Practice  of  Physic,  Censor 
of  the  State  and  New- York  Medical  Societies,  etc.,  etc. 

I  am  very  glad  to  find  the  press  engaged  in  diffusing  a  knowledge  of  the 
German  medical  literature  in  this  country.  At  the  head  of  the  German 
books  of  practice  stands  this  book  of  the  good  Hufeland.  Mr.  Bruchhausen 
and  Dr.  Nelson  have  laboured  with  diligence  and  good  faith  in  rendering  the 
Enchiridion ;  and  so  far  as  I  have  had  leisure  to  compare  their  work  with 
the  original,  I  find  no  error  of  magnitude.  Another  edition  will,  no  doubt, 
be  called  for  soon,  and  then  the  worthy  American  curators  can  dispense  with 
the  somewhat  meagre  characteristic  given  to  it  by  their  too  close  adherence 
to  the  letter  of  the  author.  I  heartily  wish  success  to  the  good  enterprise. 

JOHN  F.  GRAV,  M.D. 

New- York,  September  8, 1842. 

The  reputation  of  the  venerable  eclectic  of  Germany  scarcely  requires  en- 
dorsement even  on  this  side  of  the  Atlantic.  An.  independent  and  original 
thinker,  Hufeland,  laboured  for  the  cause  of  medical  science,  and  has  ac- 
quired a  universal  renown,  amply  attested  to  by  his  "  Journal  of  Practical 
Medicine,"  "Art  of  Prolonging  Life,"  "System  of  Practical  Medicine,"  and 
numerous  Essays,  besides  personal  contributions  of  humane  and  necessary  in- 
novations in  the  treatment  of  "Inoculation,"  "Small  Pox,"  and  "Signs  of 
Death."  His  last  work,  Enchiridion  Medicum,  concentrates  the  experience 
of  his  entire  medical  life,  and  fully  maintains  in  its  careful  and  concise  de- 
scription and  diagnosis  of  diseases  all  the  evidence  of  the  discriminating  in- 
tellect of  the  Patriarch  of  German  medical  literature. 

A.  GERALD  HULL,  M.D. 

New- York,  September  12, 1842, 


FRENCH    BOOKS. 

CRUVEILHIER.  ANATOMIE  PATHOLOGIQUE  DU  CORPS  HU- 
MAIN,  ou  Descriptions,  avec  figures  lithographiees  et  coloriees,  des  diverses 
alte  ations  morbides  dont  le  corps  humain  est  susceptible  ;  par  J.  CRUVEIL- 
HIER, p^ofes^eur  d'anatomie  pathologique  a  la  Faculte  de  Medicine  de  Paris, 
medecin  de  1'hopital  de  la  Charite,  president  perpetuel  de  la  Societe  anato- 
mique,  etc. 

Uouvrage  complet  forme  2  fort*  volumes,  relie,  grand  in-folio  avec  23Splan- 
ches-coloriees. 


VELPEAU.    NOUVEAUX    ELEMENTS    DE    MEDECINE  OPERA- 


rgie,  par  A.  A.  VELPEAU,  chirurgien  de  1'hopital  de  la  Charite,  profes- 
seur  de  clinique  chirurgicale  a  la  Faculte  de  medecine  de  Paris.  Deuxiime 
edition,  entilrement  refondue  et  augmentee  d'un  traite  de  petite  chirurgie  , 
avec  191  planches  intercalees  dans  le  texte.  Paris,  1839.  4  forts  vol.  in-8.  de 


chacun  800  pages  et  atlas  in-4.     $10. 
Avec  les  planches  de  1'atlas  coloriees. 


RASPAIL.  NOUVEAU  SYSTEME  DE  CHIMIE  ORGANIQUE,  fonde" 
sur  de  nouvelles  methodes  d'observation  ;  precede  d'un  Traite  complet  sur 
1'art  d'observer  et  de  manipuler  en  grand  eten  petit  dans  lelaboratoire  etsur 
le  porte-obiet  du  microscope  ;  par  b  .  A.  RASPAIL,  Deuxiime  tJition,  entilre- 
ment refondue,  accompagnee  d'un  atlas  in-4de  20  planches  de  figuresdessinees 
d'apres  nature,  gravees  avec  le  plus  grand  soin.  Paris,  1838,  3  forts  vol.  in-8, 
et  atlas  in-4.  §9.  • 

ENCYCLOPEDIE  ANATOMIQUE,  comprenant  1'Anatomie  descriptive, 
1'Anatomie  generate,  1'Anatomie  pathologique,  1'histoire  du  Develonpement 
et  celle  des  Races  humaines,  par  G.  T.  Bischoft',  J.  Henle,  E.  Huschke,  S.  T. 
Soemmerring,  F.  G.  Theile,  G.  Valentin,  J.  Vogel.R.  Wagner,  G.  et  E.  We- 
ber, traduit  de  1'Allemand,  Par  A.  J.  L  JOURDAN,  membre  de  PAcademie 
royale  de  medecine,  Paris,  1843,  10  volumes  in-8.  prix  de  chaque  volume, 
$1  75. 

Prix  des  2  atlas  in-4.     $3. 

G.  H.  G.  JAHR  —ELEMENTARY  TREATISE  UPON  HOMOZOPA- 
THIA,  and  the  manner  of  its  practice,  with  some  of  the  most  important  ef- 
fects of  ten  of  the  principal  Homffiopathic  remedies.  Second  French  edition, 
corrected  and  enlarged.  Translated  by  Edward  Bayard,  M.D.  1845.  50 
cents. 

NOUVEAU  MANUEL  DE  MEDECINE  HOMCEOPATHIQUE,  divi.se 
en  deux  parties,  lo  Matiire  medicate  ;  2o  Repertoire  therapeutique  et  symptd- 
matologique  ;  par  G.  H.  G.  JAHR.  Paris,  1840,  4  vol.  in-12.  §o. 

NOUVELLE  PHARMACOPEE  ET  POSOLOGIE  HOMOEOPA- 
THIQ.UES,  ou  de  la  Preparation  des  medicamens,  homoaopathiques  et  de 
1  'administration  des  doses;  par  G.  H.  G.  JAHII.  Paris,  1841,  in-  12,  relic.  $2. 

HOMCEOPATHIE  DOMESTIQUE,  comprenant  1'hygiene,  le  regime  Ji 
suivrc  pendant  le  traitement  des  maladies  et  la  therapeutique  homceopathique, 
precedee  d'une  notice  sur  1'hopital  homoeopathiqi'e  de  la  Charite  de  Vienne  ; 
par  le  docteur  BIGEL  ;  deuxieme  edition,  entierement  refondue,  par  le  doc- 
teur  BEAUVAIS  (de  Saint  Gratien).  Paris,  1839,  in-18,  de  624  pages.  $1  50. 

CLINIQUE  HOMO3OPATHIQUE,  ou  Recueil  de  toutes  les  observations 
pratiques  publiees  jusqu'a  nos  jours  ;  par  le  docteur  BEAUVAIS  (de  Saint  Gra- 
tien). Paris,  1836-1839.  Oavrage  Complet.  9  forts  volumes  in-8.  $22. 

EFFETSTOXIQUES  ET  PATHOGENETIQUES  DES  MEDICAMENS 
sur  1'economie  animate  dans  1'etat  de  sante,  recueillis  et  mis  en  tableaux 
synoptiques,  par  le  docteur  BEAUVAIS  (de  Saint-Gratien).  Paris,  1838.  Cet 
ouvrage  est  public  par  livraisons  de  cinq  feuilles  in-S,  accompagnees  de  ta- 
bleaux, (6  livraisons  sont  en  vente.)  §4. 


8  French  Books. 

EXPOSITION  DE  LA  DOCTRINE  MEDICALE  HOMCEOPATHIQUE, 
ou  Organon  dc  1'art  de  guerir,  par  S.  HAHNEMANN,  traduit  de  1'allemand  sur 
la  cinquilme  edition  avec  divers,  opuscules  de  1'auteur,  et  une  traduction  sur 
la  cinquitme  Edition  de  la  Pharmacopee  Homceopathique,  de  Harimann  ;  par 
A. J.  L.  JOURDAN.  Seconde  edition,  avec  le  portrait  de  Hahnemann.  Paris, 
1834,  in-8  de  672  pages.  $2. 

MEMORIAL  DU  MEDECIN  HOMCEOPATHISTE,  ou  Repertoire  al- 
phabetique  de  traitmens  et  d 'experiences  homceopathiques,  pour  servir  de 
guide  dans  1'application  de  I'homceopathie  au  lit  du  malade  ;  par  M.  HAAS. 
Traduit  de  1'allemand  par  A.  J.  L.  Jourdan,  Paris,  1834,  in-24.  75  cents. 

HAHNEMANN.  DOCTRINE  ET  TRAITEMENT  HOMCEOPA- 
THIQUES des  maladies  chroniques ;  par  le  docteur  S.  HAHNEMANN  ;  traduit 
de  1'allemand  par  A.  J.  L.  JOUHDAN,  membra  de  1'Academie  royale  deMede^ 
cine.  Paris,  1832,  2  vol.  in-8.  15  fr. 

HAHNEMANN.  TRAITE  DE  MATIERE  MEDICALE  PURE,  ou  de 
1'Action  homceopathique  des  medicamens  ;  par  S.  HAHNEMANW,  avec  des  Ta- 
bles proportionelles  de  1'influence  que  diverses  circonstances  exercent  sur 
cette  action  ;  par  C.  BffiNNiNGHAUSEir ;  traduit  de  1'allemand  par  A.  J.  L. 
JOURDAN.  Paris,  1834,  3  forts  vol.  in-8.  24  fr. 

Les  progr&s  que  fait  chaque  jour  la  doctrine  medicale  homoeopathique,  le 
grand  nombre  de  partisans  qu'elle  compte  rendaient  necessaire  la  publication 
d'ouvrages  qui  missent  a  meme  de  pouvoir  la  discuter  avec  connaissance  de 
cause  et  impartiality.  C'est  dans  les  ouvrages  d'Hahnemann,  son  fondateur, 
qu'il  faut  1'etudier ;  car  si  1' 'Exposition  ou  Organon  de  I'art  de  gudrir  contient 
les  principes  generaux,  c'est  damsla  Matilre  medicale  pure  et  la  Doctrine  des 
maladies  chroniques  qu'il  faut  en  suivre  1'application  pratique :  ces  trois  ou- 
vrages ferment  done  1'ensemble  complet,  theoriqueet pratique,  de  la  doctrine  ho- 
mceopathique :  la  celebrite  du  docteur  Hahnemann,  la  bonne  foi  qui  signale  ses 
productions,  commandent  de  ne  le  juger  qu'apres  examen. 

CLINIQUE  HOMCEOPATHIQUE  a  1'usage  des  medecina  et  des  gens  du 
monde,  par  L.  MALAISE,  D.M.  1837,  in-8.  relie.  $2  50. 

REVUE  DE  LA  MEDECINE  SPECIFIQUE,  par  MM.  les  docteurs 
CHARGE,  PETROZ  et  ROTH,  (Commencee  en  Janvier,  1840.)  Lesannees  1840 
et  1841,  3  vol.  in-8.  $10. 

JOURNAL  DE  LA  DOCTRINE  HAHNEMANNIENNE,  public  par  le 
docteur  MOLIN.  Paris,  1840,  2  vol.  in-8.  $5. 

ARCHIVES  DE  LA  MEDECINE  HOMCEOPATHIQUE,  publics  par 
une  societe  de  m&lecins  de  Paris.  Collection  de  juillet  1834  et  1835,  formant 
3  forts  vol.  in-8.  relie.  $6. 

La  quatrieme  annee,  tomes  7  et  8,  par  MM.  LEON  SIMON  et  LIBERT.  Paris, 
1838,  2  vol.  in-8.  reli6.  ^5  50. 

ANNALES  DE  LA  MEDECINE  HOMCEOPATHIQUE,  publides  par 
MM.  LEON  SIMON,  G.  H.  JAHR  et  CROSERIO,  docteurs  en  medecine.  Ce  jour- 
nal est  public  depuis  le  ler  mars,  1842,  tous  les  mois,  par  cahier  de  5  feuilles 
in-8.  Prix  de  1'abonnement,  pour  un  an,  $5. 

MANUEL  D'HYDROSUDOPATHIE,  ou  Traitement  des  maladies  par 
1'eau  froide,  la  sueur,  1'exercice  et  le  regime,  suivant  la  methode  de  V. 
Priessnitz,  employee  dans  1'etablissement  de  Graefenberg  ;  par  le  docteur 
BIGEL,  suivi  d'un  memoire  sur  la  chaleur  animale ;  parM.  Pelletan,  professeur 
k  la  facultfe  de  medecine  de  Paris.  Paris,  1840,  grand  in-18.  relie.  $1  50. 

EXPOSITION  DES  METHODES  HYDRIATIQUES  DE  PRIESSNITZ 

dans  les  diverses  especes  de  maladies,  consid^rees  en  elles-memes  et  compa- 
rees  avec  celles  de  la  medecine  allopathique,  par  les  docteurs  H.  HEIDEN- 
HAIN  et  H.  EHRENBERG.  Paris,  1842,  in-18  grand  papier.  $1  50.  • 

QC?=  On  donnera  gratis  un  Catalogue  complet  de  Livres  de  Medecine,  Chi- 
rurgie,  Anatomic,  Physiologic,  Histoire  Naturelle,  Physique,  Chemie,  Phar- 
macie. 


\Qj&s**-4**  <\,    r  n.  A  v^  y  J 

H  ARTM  AN  N^S 


THEORY 


ACUTE    DISEASES 

AND    THEIR 

HOMOEOPATHIC     TREATMENT 

THIRD  GERMAN  EDITION, 

REVISED  AND  CONSIDERABLY  ENLARGED  BY  THE  AUTHOR. 

TRANSLATED,  WITH  ADDITIONS, 

AND  ADAPTED  TO  THE  USE  OF  THE  AMERICAN  PROFESSION, 

BY   CHARLES   J.    HEMPEL,    M.  D. 
VOL.  I. 

NEW-YORK: 
WILLIAM  RADDE,  322  BROADWAY. 

PHILADELPHIA: — c.  L.  RADEMACHER,  39  NORTH  FOURTH»ST. 

BOSTON  : — OTIS    CLAPP,    12   SCHOOL-ST. 

1847. 


Vv 


Entered,  according  to  Act  of  Congress,  in  the  year  1847,  by 

WILLIAM     RADDE, 

In  the  Clerk's  Office  of  the  District  Court  of  the  United  States,  for  the 
Southern  District  of  New  York. 


H.  LCDW10,  PRINTER,  TO  *  «  VKKY-gT.,  H.  t. 


THE  TRANSLATOR'S  PREFACE, 


THE  second  volume  of  Hartmann's  Acute  Diseases  will  appear 
very  shortly. 

We  have  nothing  to  mention  in  regard  to  the  mode  in  which 
this  work  is  to  be  used.  It  should  be  read  and  studied  from 
beginning  to  end;  that  is  all. 

As  this  work  is  intended  for  practitioners  generally,  begin- 
ners as  well  as  those  who  are  more  advanced  in  our  practice, 
it  may  be  proper  to  give  a  brief  explanation  of  the  various 
modes  in  which  our  medicines  may  be  administered.  We  have 
nothing  to  say  about  the  frequency  or  magnitude  of  the  doses, 
as  the  reader  wiU'find  that  subject  fully  explained  and  inquired 
into  in  the  body  of  the  work.  All  that  we  wish  to  do  in  this 
place,  is  to  inform  the  beginner  of  the  various  modes  in  which 
the  medicines  may  be  given  to  the  patient. 

Administration  of  the  pellets. — Two  or  three  pellets  may 
be  placed  upon  the  patient's  tongue,  taking  care,  however,  that 
the  mouth  should  be  well  washed  previously.  If  the  complaint 
should  be  of  such  a  nature  as  will  evidently  require  more  than 
one  dose  of  the  medicine,  the  pellets,  seven  or  eight  in  number, 
may  be  dissolved  in  half  a  tumblerful  of  water,  turning  the  so- 
lution some  twenty  times  from  one  tumbler  into  another  one 
backwards  and  forwards ;  the  tumblers  should  be  well  cleansed 
and  dried  before  using  them ;  nothing  fuzzy  should  be  left 
hanging  about  them.  Never  use  the  same  tumbler  for  two  dif- 
ferent kinds  of  medicine.  Let  not  the  solution  be  exposed  to 


Xll.  PREFACE. 

the  light,  keep  the  tumblers  covered,  and  use  a  separate  spoon 
for  each  medicine. 

Administration  of  powders. — If  the  patient  should  prefer 
taking  the  medicine  in  powders,  use  one  drop  of  the  medicine 
to  about  twenty  or  twenty-five  powders ;  a  powder  should  not 
weigh  more  than  one  grain. 

Administration  of  the  tinctures. — The  tinctures  should  al- 
ways be  given  in  water,  one  or  two  drops  in  a  tumblerful, 
stirring  the  solution  well. 

Administration  of  the  lower  trituralions. — No  trituration 
below  the  third  should  be  given  in  water,  but  always  in  one- 
grain  powders. 

Hahnemann's  favourite  mode  of  adrniuistering  the  remedies 
was  this :  he  dissolved  a  few  pellets  in  a  tumblerful  of  water, 
in  the  manner  which  has  been  indicated  above,  and  then  mixed 
a  tablespoonful  of  that  solution  with  another  tumblerful  of 
water,  turning  the  solution  twenty  or  thirty  times  from  one 
tumbler  into  another  backwards-  and  forwards.  This  double 
mixing  is  very  often  required  with  the  tinctures.  A  simple 
mixture  of  the  tincture  will  frequently  be  found  inefficient, 
whereas  a  doubly-mixed  tincture  has  the  best  effect,  provided 
the  remedy  is  the  true  one. 

Any  medicine  which  is  taken  in  water  should  be  turned  five 
or  six  times  from  one  tumbler  into  another,  previous  to  taking 
a  new  dose. 

CHARLES  J.  HEMPEL,  M.D. 


THE  AUTHOR'S  PREFACES 


TO    THE   THREE    EDITIONS    OF   THIS   WORK 


CONDENSED    INTO   ONE. 


FOR  the  last  ten  years  the  homoeopathic  science  and  art  of  healing 
has  been  considerably  perfected  in  all  its  branches ;  but  no  work 
has  as  yet  been  published  which  furnishes  a  systematic  exposition 
of  the  treatment  which  ought  to  be  adopted  in  the  different  dis- 
eases. This  omission  is  probably  owing  in  part  to  the  inherent 
difficulty  of  the  undertaking,  and  partly  to  Hahnemann.  having  re- 
marked that  no  treatment  can  be  based  upon  the  classification  of 
diseases  as  adopted  by  the  old  school.  I  have  never  despaired  of 
succeeding  in  completing  a  work  containing  a  systematic  exposi- 
tion of  the  homoeopathic  treatment  of  disease,  so  much  more  as  the 
phenomena  which  constitute  the  diseases,  as  described  in  allopa- 
thic books,  are  contained  among  the  symptoms  obtained  by  the 
provers  of  drugs,  such  as :  asthma  Millari,  cholera  morbus,  fever 
and  ague,  and  its  varieties.  It  is  the  very  plan  which  has  been 
adopted  by  the  author  of  homoeopathy,  of  arranging  the  symptoms 
of  a  drug  in  one  list,  and  of  distributing  them  in  groups,  that  has 
suggested  to  me  the  idea  and  arrangement  of  the  present  work. 
I  trust  I  have  rendered  a  service  to  beginners,  by  describing  the 
general  diagnostic  characteristics  of  a  disease  at  the  commence- 


XIV.  AUTHOR  S    PREFACES. 

ment  of  the  chapter ;  the  more  particular  indications  for  the  special 
remedies  have  not  been  omitted. 

My  remarks  on  diagnosis,  prognosis,  etiology,  classification  of 
diseases,  are  necessarily  very  brief,  and  may  call  forth  censure  on 
the  part  of  allopathic  physicians.  My  object  has  been  to  furnish 
an  accurate  account  of  the  homoeopathic  treatment  of  disease.  As 
regards  the  generalities  and  the  collateral  sciences  in  medicine,  1 
had  a  right  to  expect  that  every  homoeopathic  practitioner  should 
be  thoroughly  acquainted  with  them.  Some  allopaths  may  find 
fault  with  the  distribution  of  the  work ;  to  such  critics  I  have 
simply  to  observe  that  the  distribution  of  the  work  has  been  a 
matter  of  secondary  importance,  and  that  my  main  object  in  adopt- 
ing any  classification  of  disease  has  been  to  establish  points  of 
reference  which  would  facilitate  the  use  of  the  work ;  the  treatment 
and  nature  of  diseases  do  not  depend  upon  their  classification. 
Certain  diseases,  which  are  considered  chronic  by  allopathic  phy- 
sicians, have  been  transferred  to  the  acute  forms  of  disease ; 
my  reasons  for  making  this  change  have  been  stated  in  treating  of 
those  diseases. 

It  is  more  than  probable  that  indolent  and  indifferent  practition- 
ers will  avail  themselves  of  this  work  as  a  means  of  avoiding 
study  and  labour.  To  all  such  I  would  repeat  the  words  of  Pfeuf- 
fer,  which  may  be  found  in  his  "  Deceptions  at  the  Sick-Bed. " 
"  Every  case  of  disease,  in  spite  of  the  physiognomic  character 
which  it  may  possess  in  common  with  other  diseases,  is  an  indi- 
vidual existence  or  form,  upon  which  the  dogmatism  of  the 
schools  will  be  frequently  wrecked.  The  power  to  indi- 
vidualize distinguishes  the  true  physician  from  the  routinier, 
whose  rules  and  principles  diminish  as  he  advances  in  his  prac- 
tice." 

The  present  work  purports  to  be  the  mere  outline  of  a  future 
system  of  therapeutics,  although  such  a  system  can  never  be  made 
complete  enough  to  give  the  beginners  fixed  rules  for  the  treat- 


AUTHOR  S    PREFACES.  _  XV. 

0 

ment  of  every  case,  inasmuch  as  every  case  ought  to  be  considered 
a  distinct  affection  which  has  never  existed  before  in  precisely  the 
same  form,  and  for  which  no  remedy  can  be  pointed  out  before- 
hand (except  a  few  contagious  and  miasmatic  diseases,  such  as  : 
scarlatina,  measles,  smallpox,  purple-rash,  syphilis,  etc.).  This 
observation,  which  has  been  so  frequently  repeated  by  homoeopa- 
thic physicians,  ought  to  convince  allopaths  that  their  opponents 
cannot  cure  disease  unless  they  possess  the  power  to  investigate 
the  symptoms  and  the  perceptible  character  of  a  disease  with 
great  accuracy,  which  they  cannot  do  without  a  profound  know- 
ledge of  anatomy,  physiology,  pathology,  etc.  Why  then  should 
homoeopaths  be  called  ignorant,  as  has  so  often  been  the  case? 

According  to  homoeopathy,  congestion,  fever,  inflammation, 
constitute  the  second  phasis  of  a  disease,  which  depends  upon  a 
morbid  alteration  of  the  nervous  system.  Starting  from  this 
ground  I  ought  to  have  treated  in  the  first  place  the  affections  of 
the  nervous  system  ;  I  have  preferred  preserving  the  common 
division  of  diseases,  in  order  to  avoid  all  unnecessary  and 
embarrassing  innovations.  In  describing  the  symptoms  of  dis- 
eases I  have  observed  the  following  order :  those  of  the  irritable 
sphere  first;  next,  those  of  the  reproductive  and  sensitive  sphere; 
and,  lastly,  some  affections  of  the  sexual  organs,  to  which  the 
diseases  of  females  have  been  added,  including  the  diseases  of 
the  female  sexual  organs. 

The  inflammatory  affections  of  the  male  sexual  organs  will  be 
found  described  in  the  chapter  on  blennorrhcea  of  the  male 
urethra. 

No  essential  changes  have  been  made  in  the  three  editions  of 
this  work,  except  some  changes  in  the  arrangement  of  the 
materials  and  practical  observations  derived  from  my  own  ex- 
perience and  that  of  my  friends.  As  regards  the  fundamental 
principles  of  our  art,  I  can  truly  say,  that  I  am  more  than  ever 
convinced  of  their  truth,  and  that  I  cherish  particularly  the  great 


XVI.  AUTHORS    PREFACES. 

principle  of  selecting  a  remedy  in  accordance  with  the  perceptible 
phenomena  of  the  disease.  I  have,  moreover,  become  convinced, 
that  Hahnemann  was  right  in  exacting  the  most  minute  examina- 
tion of  a  case ;  although  he  has  modified  his  original  views  in 
many  respects,  yet  he  has  constantly  insisted  with. an  unyielding 
firmness  upon  the  necessity  of  making  a  rigid  examination. 
Homoeopathy  would  perish,  if  we  were  to  neglect  that  most 
important  part  of  the  treatment. 

I  have  now  practised  homoeopathy  for  twenty-eight  years,  and 
my  practice  has  been  very  extensive.  This  long  period  has 
afforded  me  abundant  opportunities  of  becoming  aware,  that  our 
knowledge  of  the  internal  character  of  disease  is  yet  very 
imperfect,  and  that  we  have  not  even  yet  discovered  a  cor- 
responding simile  for  every  disease.  Nevertheless,  I  cannot 
chime  in  with  the  wild  innovations  of  the  pretended  modern 
reformers  of  homoeopathy.  We  should  prove  all  things  and  hold 
fast  to  those  that  are  good ;  but,  on  the  other  hand,  we 
ought  not  to  abandon  a  single  rule  or  opinion,  without  having 
become  convinced  by  rigid  and  impartial  investigation,  that  it  is 
either  useless  or  erroneous. 

F.  HARTMANN,  M.D. 

LEIPSIC,  Sept.  21st,  1&16. 


CONTENTS. 


Page 

INTRODUCTION.  25 

Fundamental  Principle, 26 

Proving  of  Drugs,                    .      '  .     - 28 

Investigation  of  the  Symptoms,  .......  29 

Causa  Occasionalis,  Necessity  of  Investigating  the,         .         .         .31 

Examination  of  a  Case,       .                 32 

CLASSIFICATION  OF  DISEASES.  38 

Diseases  belonging  to  particular  Ages, 39 

"             Different  sexes, 39 

"  "  Trades  and  Professions,  .         .         .       .  .         .40 

"       Sporadic, 40 

"       Endemic, 40 

"       Epidemic,                                .    • 41 

"       Annual, 41 

"       Stationary,           .         .         .                           .         .         .  41 

"       Intermittent,                      <                 41 

"       Hereditary, 43 

"       Congenital, 43 

"       Acquired, 44 

"      Primary, 44 

"       Secondary, 44 


XV111.  CONTENTS. 

Page 

Diseases,  Contagious, 44 

"       Miasmatic, 44 

"       Acute 45 

"       Chronic,        .........  45 

"       of  the  Mind,              .        • 4? 

GENERAL  THERAPEUTIC  RULES.  50 

Different  Modes  of  Treatment, 52 

Treatment,  Specific, .  •     .  52 

"          Prophylactic, 52 

"          Palliative,            53 

"          Derivative, 56 

"          Empirical,            .........  57 

"         Isopathic, 58 

Dose,  Magnitude  of, 60 

Dynamization,   ..........  61 

Modus  Operandi  of  our  remedial  agents,  .        .  .         .71 

Division  of  our  remedies  into  antiphlogistics  and  antipsorics,           .  74 
Repetition  of  doses,        .........  77-79 

Mixing  the  remedies, ..........  78 

Diet,  General 81 

FEVER. 

GENERAL    REMARKS. 

Common  Symptoms  of  Fevers,             85 

Causes  of  Fevers, 86 

Critical  Phenomena, 86 

"      Sweat 87 

"      Rash, 88 

"      Urine, 89 


CONTENTS.  XIX. 

Page 
angeable  Urine, 89 

Critical  Hemorrhage, 90 

Dangerous  Hemorrhage  in  Fevers,      .         .  .         .         .      90-92 

Critical  Discharges  from  the  Bowels,      .        .        .        ...        .93 

"      Vomiting, 93 

"      Expectoration, 93 

"      Ptyalism, 94 

GENERAL   REMOTE    CAUSES    OF    FEVER.  94 

Atmospheric  Air, 95 

Contagia,   ...........          95 

Miasmata,     .         .         .         .         .         .         .         .         .         .         .95 

Passions  and  Emotions, <    .          96 

Derangements  of  the  Intestinal  Canal, 96 

Want  of  Necessaries,          ...'.'.. 97 

CLASSIFICATION    OF    FEVERS.  97 

Fevers,  Synochal,      •.'.--. 97 

"       Synochus,              .  • 98 

"       Typhoid,        -..--.•.. 98 

"       Torpor,           .'•'.-.- 98 

Prognosis, 100 

Terminations, •""..-.        .        .  101 

Diet,  .        .        ..•.-.-...  .102 

Temperature,      ..........  103 

SPECIAL  PATHOLOGY  OF  FEVERS. 

FIRST   CLASS. 

Synochal  Fevers 108 

Pathology 110 

Treatment, Ill 


XX.  CONTENTS. 

Page 

Fever  of  Dentition, 115 

Teething,  Pathology  of, 116 

Diseases  occurring  during  the  period  of  Teethbig,     .         .         .  116 

Spasms  and  Convulsions, 120 

SECOND   CLASS. 

Catarrhal  Fever, 123 

"            "        in  Children, 133 

Influenza, 135 

Grippe,           .        .        .        .        .        .        .        .        .        .       •  136 

THIRD   CLASS. 

Simple  Rheumatic  Fever, 140 

FOURTH    CLASS. 

Gastric  Fevers,               151 

Status  Gastricus,          .         .         .         .         .         .         .         .  151 

Saburral,  Gastric,  Bilious  Fevers, 154 

Mucous  Fevers, 165 

Status  Pituitosus,             .        . 168 

.Worm  Fever,              172 

Ttenia, 179-182 

Febrile  Conditions  resembling  Cholera,       .         .         .         .         .  182 

Cholera,  Sporadic, 184 

"       Asiatic, 187 

Dysentery, 202 

"        Inflammatory,            .        .        .        .        .        .        .  .  206 

"         Gastric, 208 

"         Bilious,                209 


CONTENTS.  XXI. 

Tage 

Dysentery,  Pituitous, 209 

"        Mucous,     .        .        .'                210 

"        Worm, 212 

"         Putrid,        .         .         ,.-.'.         .         .         .  213 

Diarrhoea,                .         .""."..'                r       .         .         .         .  214 

"        Stercoralis,           •'       •* 215 

"        Aquosa,           .         .'        '.        .'.'".'.         .         .  215 

"        Biliosa,                  .:       .*.     .'.''.'.        .         .  217 

"        Mucosa,          .' '      .        .                 .        ,        .        .        .  219 

FIFTH   CLASS. 

Typhus,          -.';•-        .        .      ....         *       .        .  220 

Diagnosis,               .                  .         .         . ''      '-.        .        .        .         .  221 

Varieties  of  Typhus,        •  ./     '.      .  .        »        .         .         .         .  221 

Typhus  Cerebralis, 221 

"        Abdominalis,          .        . 222 

"        Pneumo-          .'.-.. 222 

Remote  Causes  of  Typhus,        .         . 223 

Prognosis, 224 

• 

Terminations,              224 

Treatment,             225 

Typhus  Stupidus, 234 

"       Gastricus,          ,'...-       .    -    .        .        .        .        .  238 

"      Arising  from  other  Diseases,         ' .      . «    '  .  '      .     .  .  245 

Diet  in  Typhus,          •'  .        ....'.    r   .        .        .251 

Typhus  Putridus,                .     x  ..-.-..        .        .        .  252 

"       Contagiosus,       .        .        .        »        .        .        .         .         .  254 

"       Pestilentialis, 255 

Yellow  Fever,        .        .        .    •    .        .        .        .        .        .        .255 

Typhus  Lentus, 256 


XX11.  CONTENTS. 

SIXTH    CLASS. 

Page 

Intermittent  Fevers,               258 

Causes, 261 

Treatment,               261 

Endemic  Intermittent  Fevers,             261 

Intermittent  Headache, 268 

Drug-Diseases, 269 

China-Cachexia,             .        .        .        ...        .        .  '      .  269 


ERRATA. 

Page  47,  llth  line  from  the  bottom — after  originate  add  in  psora. 
"   103, 16th    "      "      "    top— for  25°  read  57°,  and  /("-  45°  read  77«. 
"    "    17th  "      "     "     "  —  "  35°    "    67%   "      «   38°     "    70'. 


INTRODUCTION. 


IT  is  now  more  than  fifty  years  since  homoeopathy 
was  discovered  by  the  profound  and  learned  Dr.  Hah- 
nemann.  Its  claims  and  merits  are  now  universally 
appreciated,  and  in  spite  of  the  intrigues  and  invec- 
tives of  its  opponents,  it  has  succeeded  in  gaining 
the  rank  of  an  acknowledged  science.  It  owes  its 
triumph  to  the  fact  that  the  principles  of  homoeopathy 
are  generalizations  established  in  the  eternal  and  im- 
mutable household  of  nature.  During  the  first  twenty 
years  of  his  discovery,  Hahnemann  was  alone  in  cul- 
tivating and  perfecting  it ;  but  after  that  period  he 
formed  disciples  ;  physicians  from  the  old  school,,  who 
at  first  considered  homoeopathy  a  mere  creation  of  the 
fancy,  became  converts  to  the  new  doctrine,  and,  at 
the  present  moment,  it  is  triumphantly  practised  in 
every  civilized  country,  and  not  only  spreads  farther  and 
farther,  but  its  intrinsic  value  is  likewise  being  con- 
stantly enhanced  by  new  discoveries.  This  success 
could  only  be  accomplished  by  a  mode  of  cure  which 
is  derived  from  the  laws,  of  nature,  and  is  confirmed 
every  day  by  the  results  of  experience.  But  what  will 
be  the  influence  and  extent  of  homoaopathy  when  its 
practitioners  shall  have  increased  by  thousands,  and 
shall  devote  all  their  energies  to  the  development  of 
their  art ;  heedful  of  the  warning  of  their  master,  that 
no  created  spirit  can  penetrate  to  the  causative  prin- 
ciples of  nature  without  substituting  in  their  stead 
speculative  and  hypothetical  explanations  and  opinions 
and  receding  more  and  more  from  the  paths  of  nature? 
We  may  certainly  hope,  without  being  sanguine,  that 
after  the  next  fifty  years,  homcBopathy  will  be  far 
2 


26  s     INTRODUCTION. 

If 

ahead  of  any  other  system  of  cure.  Be  it  remember- 
ed, however,  that,  in  order  to  attain  such  brilliant  re- 
sults, all  homcEopathic  practitioners  ought  to  devote 
themselves  to  calm  inquiry  and  rigid  observation,  and 
that  their  efforts  in  the  great  cause  ought  never  to 
slacken. 

However  interesting  it  might  be  to  our  readers  to 
glance  in  this  place  over  a  detailed  account  />f  the 
mode  in  which  Hahnemann  gradually  arrived  at  the 
discovery  and  realization  of  his  system,  yet  we  prefer 
omitting  the  relation  of  facts  with  which  our  readers 
are  abundantly  familiar,  and  confine  ourselves  to 
stating  the  fundamental  principles  of  homoeopathy ; 
these  form  a  complete  system  of  general  therapeutics, 
and  a  correct  knowledge  of  those  principles  is  essen- 
tial to  the  proper  understanding  and  appreciation  of 
the  special  principles  of  our  treatment  of  disease. 

The  fundamental  principle  of  homoeopathy  is  ex- 
pressed in  these  \vords  :  "  Similia  similibus  curantur,'T 
which  means,  that  only  such  remedies  are  capable  of 
effecting  a  permanent  and  real  cure  as  affect  the 
healthy  organism  in  a  manner  similar  to  the  natural 
disease.  This  fundamental  principle  of  cure  was  dis- 
covered by  Hahnemann  \vhile  he  translated  Cullen's 
Materia  Medica  (Leipsic,  1790),  where  his  attention 
was  arrested  by  the  statements  about  the  febrifuge 
power  of  Cinchona.  Upon  proving  this  drug  on 
healthy  persons,  a  state  similar  to  fever  and  ague  was 
realized  in  the  provers,  beside  many  other  symptoms 
which  had  never  been  mentioned  by  any  writer  before. 
From  this  fact  Hahnemann  inferred  what  was  after- 
wards confirmed  as  a  great  truth,  that  medicines  are 
only  in  so  far  capable  of  curing  disease  as  they  realize 
in  a  healthy  person  a  morbid  state  similar  to  the  natu- 
ral disturbance  of  the  organism.  Led  by  his  experi- 
ence, Hahnemann  established  the  following  rule  for 
the  further  development  of  his  system  : 

Prove  the  drugs  upon  healthy  persons,  in  order  to  find 
out  what  systems  and  organs  are  principally  affected 
by  them  and  what  are  the  symptoms  characterizing 


INTRODUCTION.  27 

that  affection.  It  is  true  that  the  necessity  of  such 
provings  had  been  perceived  by  single  physicians,  and 
that  partial  provings  have  been  instituted  before  Hah- 
nemann ;  but  they  were  never  carried  on  systemati- 
cally with  a  view  of  obtaining  a  correct  knowledge  of 
the  curative  powers  of  drugs  and  applying  them  to  the 
treatment  of  disease  according  to  a  fixed  general 
principle.  The  road  of  pure  experimentation  was  soon 
abandoned  by  those  physicians  as  too  tedious  and  too 
little  productive  in  brilliant  results  ;  their  prejudices 
were  likewise  opposed  to  a  systematic  proving  of 
drugs,  and  Hahnemann  is  therefore  the  first  who  has 
proclaimed  and  demonstrated  the  necessity  of  pure 
experimentation,  who  has  furnished  explicit  and  abun- 
dant rules  for  the  proving  of  drugs,  and  who  has  fur- 
nished to  the  world  the  brilliant  results  of  his  own 
provings,  which  are  the  groundwork  of  homoeopathy 
and  a  beacon-light  and  model  for  all  homoeopathic 
practitioners  and  pure  experimenters. 

However  laborious  and  painful  the  road  of  pure  ex- 
perimentation may  be,  Hahnemann  never  dreaded  the 
tortures  and  sacrifices  which  he  encountered  on  that 
road,  and,  assisted  by  devoted  disciples,  he  continued 
his  provings  and  noted  the  symptoms  which  he  ob- 
tained, with  the  utmost  care.  Provers  of  drugs  ought 
to  employ  the  greatest  discretion  and  care  in  observing 
the  drug-symptoms  which  they  experience  during  the 
period  of  proving ;  and  they  ought  moreover  to  observe 
a  rigorous  diet  during  all  that  time,  lest  the  action  of 
the  drug  should  be  impaired  and  the  symptoms  should 
become  impure  and  untrustworthy.  In  proving,  Hah- 
nemann soon  discovered  that  the  drugs  had  a  twofold 
effect,  which  he  designates  in  his  Organoii  by  the 
terms  of  primary  and  secondary,  and  which  had  never 
been  observed  before  by  any  physician.  Without 
entering  upon  an  explanation  of  that  compound  action, 
which  may  be  found  in  the  Organon  and  to  which  we 
therefore  refer,  we  content  ourselves  with  simply  re- 
marking, in  this  place,  that  the  primary  effect  of  the 
drug  is  sometimes  seen  in  disease  in  the  shape  of  a 
temporary  exacerbation  of  the  original  symptoms. 


28  INTRODUCTION. 

Such  an  exacerbation,  however,  is  much  less  frequent 
than  is  supposed.  Most  of  the  pYetended  exacerba- 
tions which  are  recorded  in  our  books  have  been 
noticed  by  beginners  in  homoeopathy,  who  had  too 
little  knowledge  of  disease  and  the  effects  of  the 
remedies  to  be  able  to  distinguish  a  natural  from  a 
medicinal  exacerbation  of  the  symptoms  ;  or  Hahne- 
mann  himself  was  carried  away  by  his  own  enthusi- 
asm, anoKhis  disciples  Avere  either  too  timid  or  too 
ignorant  to  correct  the  errors  of  his  judgment ;  or  the 
exacerbation  might  have  been  owing  to  the  excessive 
magnitude  of  the  dose  or  the  non-homcEopathicity  of 
the  remedial  agent.  We  know  that  exacerbations 
may  exist,  but  they  are  less  frequent  now  than  they 
were  in  the  beginning  of  homoeopathy,  when  every 
aggravation  of  the  symptoms  was  supposed  to*  be 
owing  to  the  excessive  'magnitude  of  the  dose.  This 
error  has  frequently  proved  injurious  to  the  patient 
inasmuch  as  it  induced  the  omission  of  many  things 
which  ought  to  have  been  done  and  which  are  done  by 
the  present  practitioners  of  homoeopathy  whose  know- 
ledge of  the  course,  chances,  transitions,  and  the  gene- 
ral characteristics  of  disease,  is  much  better  than  that 
of  their  predecessors.  It  is  still  more  difficult  to  ac-  / 
count  for  the  exacerbation  which  is  said  to  be  pro-  \ 
duced  by  the  recently-introduced  highest  potencies. 

The  proving  of  drugs  affords  a  twofold  advantage. 
In  the  first  place  the  proving  physician  sharpens  his 
power  of  observation  and  accustoms  himself'  to  no- 
tice the  minutest  symptoms  of  disease,  every  one  of 
which  ought  to  be  of  sufficient  importance  to  the  physi- 
cian to  embody  it  in  his  record  of  the  case ;  and,  in 
the  second  place,  by  proving  the  drug  upon  himself,  he 
acquires  a  true  perception  of  its  curative  powers,  which, 
in  his  person,  manifest  themselves  unbiassed  and  unmix- 
ed with  the  heterogeneous  influences  of  other  medicinal 
agents.  How  different  is  the  homoeopathic  materia 
medica  from  that  of  the  old  school,  which  is  a  mere  as- 
semblage of  impure  and  uncertain  effects  of  drugs  as 
observed  at  the  sick-bed,  and  not  of  one  drug  at  a  time, 
but  every  drug  being  administered  in  company  with  a 


INTRODUCTION.  29 

variety  of  other  drugs,  and  the  whole  being  adorned 
•with  strange  speculative  views  about  the  chemical, 
dynamic,  clinical,  mechanical  and  specific  virtues  of  a 
drug.  No  sort  ofi  reliance  can  be  placed  upon  such 
statements.  If  the  materia  medica  of  the  old  school 
is  to  be  used  with  confidence,  it  must  be  constructed 
like  our  own,  and,  in  that  case,  it  will  be  merged  in 
homoEopathy ;  for  the  homoeopathic  law  is  confirmed 
in  all  cases  where  the  pathogenetic  effects  of  our 
drugs  and  the  curative  results  which  have  been  ob- 
tained by  means  of  them,  are  compared  with  one 
another. 

The  investigation  of  the  symptoms  of  a  disease  is  the 
third  fundamental  rule  in  homoBOpathy.  The  impor- 
tance of  that  investigation  has  been  urged  by  Hahne- 
mann  with  great  force,  because  the  proper  selection 
of  the  remedial  agent,  and  consequently  the  success  of 
the  treatment  depend  upon  it.  He  recommends  that 
the  symptoms  of  the  disease  be  noted  with  the  same 
care-  and  completeness  as  were  the  symptoms  of  the 
drug,  and  that  the  former  be  counterbalanced  and  ef- 
faced by  the  latter.  This  proposition  has  been  at- 
tacked on  all  sides,  and  has  been  strangely  misappre- 
hended. It  has  been  supposed,  for  instance,  that 
Hahnemami  neglected  to  take  cognizance  of  the  ex- 
citing cause,  the  causa  occasionalis  of  the  disease. 
The  opponents  of  homosopathy  have  frequently  charged 
that  neglect  upon  our  practice ;  but  unjustly  so,  for 
every  homoeopathic  practitioner  knows,  that,  in  many 
cases,  the  proper  selection  of  the  remedial  agent  de- 
pends exclusively  upon  a  knowledge  of  that  cause,  in- 
asmuch as  the  symptoms  of  two  entirely  different  dis- 
eases may  apparently  be  alike,  and  the  difference  can 
only  be  recognised  by  tracing  the  symptoms  to  the  ex- 
citing cause.  We  will  illustrate  this  by  a  few  ex- 
amples : 

We  know  from  experience  that  Arjjjca  is  most  use- 
ful in  diseases  resulting  from  blows,  contusions, 
wounds,  strains,  etc. — A  man  who  httifbeen  drenched 
to  the  skin  is  frequently  attacked  with  a  variety*  of 
symptoms  corresponding  to  those  of  Rhus  tox.,  which 


30  INTRODUCTION. 

it  would  be  difficult  to  cure  if  the  exciting  cause  were 
not  known.— £-What  physician  would  not  give  Cpcculus 
against  a  febrile  state  characterized  by  flushed^cheeTCs 
and  nightly  sleeplessness,  if  he  knwv  that  home-sick- 
ness was  the  exciting  cause  ?-i-Fright  occasions  a 
great  many  symptoms  for  which  we  have  specific 
remedies  in  our  materia  medica ;  Ignatia  for  grief, 
Aconite  for  a  vexed  and  irritable  mood,  Opium  for 
fear. — Ignatia  is  a  sure  specific  for  symptoms  result- 
ing from  grief  and  chagrin  ;  Chamomilla,  on  the  con- 
trary, is  a  specific  for  the  consequences  of  chagrin, 
when  accompanied  with  anger  and  vehemence. — It 
would  be  a  long  and  difficult  business  to  cure  a  de- 
rangement of  the  stomach,  if  the  physician  did  not 
know  the  exciting  cause ;  but  it  will  be  readily  re- 
moved by  a  dose  of  Pulsatilla,  if  it  had  been  occasion- 
ed by  fat  food,  especially  pork  ;  by  Arsenic,  if  it  owes 
its  existence  to  a  cold  in  the  stomach,  to  eating  cold 
fruit,  etc. — Physical  and  mental  weakness  resulting 
from  blood-letting,  hemorrhage,  waking,  night-sweats, 
onanism,  venereal  excesses,  etc.,  finds  a  specific  in 
China,  provided  the  weakness  is  the  principal  suffer- 
ing, and  not  a  mere  symptom  of  a  more  general  and 
deeper-seated  disease.— i-Diseases  resulting  from  want 
of  exercise,  yield  to  Nux  ;?but  could  they  be  cured  as 
readily  if  the  exciting  cause  were  not  known  ? — Dulca- 
mara is  the  specific  for  diarrhoea,  with  or  without  colic, 
occasioned  by  cold,  and  sometimes  accompanied  \vith 
swelling  of  the  glands. — A  homoeopathic  physician 
who  is  acquainted  \vith  the  pure  effects  of  Chamomil- 
la, Mercurius,  Sulphur,  China,  Valeriana,  Iodine,  etc., 
will  never  prescribe  those  remedies  without  inquiring 
in  the  first  place  whether  the  symptoms  have  not  been 
occasioned  by  the  excessive  use  of  those  substances, 
in  which  case  he  would  administer  suitable  antidotes. 
— Would  it  be  easy  to  cure  the  sufferings  resulting 
from  the  excessive  use  of  ardent  spirits,  if  the  exciting 
cause  were  not  known?  It  would  not,  if  the  physi- 
cian were  ignorant  of  the  exciting  cause,  and  of  the 
pure  effects  of  Nux  vom.,  which  correspond  to  the 
symptoms  occasioned  by  spirituous  drinks. 


INTRODUCTION.  31 

These  examples,  which  might  be  multiplied  by 
many  more,  will  suffice  to  show  the  importance  of  in- 
vestigating the  causa  occasionalis,  and  will  at  the  same 
time  silence  the  accusation  of  our  opponents,  that  the 
investigation  of  the  causa  occasionalis  is  neglected  by 
practitioners  of  our  school. 

Homoeopathic  physicians  know  just  as  well  as  the 
physicians  of  the  old  school,  that  the  visible  symptoms 
of  a  disease  are  accompanied  with  changes  in  the  in- 
ternal organism,  which  are  considered  the  essence  of 
the  disease  by  allopathic  physicians.  Homoeopathic 
physicians,  however,  do  not  believe,  that  we  can  have 
a  sufficiently  clear  perception  of  those  changes  to  base 
upon  them  our  principles  of  cure.  Homosopathic 
practitioners  are  guided  by  the  visible  symptoms  in 
selecting  the  appropriate  remedial  agent ;  without  de- 
nying the  existence  of  the  first  cause  of  the  disease 
they  observe  with  especial  care  the  symptoms  of  the 
disease,  and  consider  them  sufficient  indications  of 
cure.  Homoeopathy  accepts  the  symptoms  which  we 
are  now  able  to  obtain  by  means  of  auscultation  and 
percussion,  and  which  aid  us  in  establishing  a  correct 
diagnosis ;  by  means  of  auscultation  and  percussion, 
and  even  by  the  investigation  of  the  pathological 
changes,  we  obtain  a  more  accurate  knowledge  of  the 
internal  phenomena  of  the  disease,  and  avail  ourselves 
of  that  knowledge  wherever  we  can  improve  and 
complete,  by  its  means,  the  application  of  our  thera- 
peutic law.  In  order  to  apply  this  law  to  the  patho- 
logical phenomena  we  shall  have,  in  the  first  place,  to 
ascertain  what  drugs  will  produce  similar  phenomena 
in  the  healthy  organism.  We  need  not  to  mind  the  re- 
proach of  curing  merely  by  symptoms  ;  years  of  expe- 
rience have  sufficiently  shown  that  a  disease  is  cured 
when  its  symptoms  cease  to  exist. 

The  investigation  of  the  symptoms  of  the  disease  re- 
quires to  be  made  with  the  greatest  care  and  correct- 
ness ;  not  even  the  slightest  symptom  ought  to  be 
omitted.  On  taking  such  a  record  of  the  symptoms, 
every  case  of  disease  will  necessarily  appear  as  a 
distinct,  individual  case  which  has  never  occurred  be- 


32  INTRODUCTION. 

fore.  This  explains  why  Hahnemann  denied  the 
validity  of  allnosological  classifications,  as  a  means  of 
cure,  and  admitted  their  use  only  for  the  purpose  of 
collecting  the  symptoms  under  one  general  denomina- 
tion. In  the  present  work  we  have  retained  the 
pathological  denominations,  because  we  are  persuaded 
that  they  facilitate  the  study  of  homoaopathy  to  the 
beginner  ;  we  have  indicated,  however,  with  as  much 
care  as  we  were  able,  the  specific  remedies  for  the 
various  groups  of  symptoms  occurring  in  a  disease ; 
and  we  expect,  therefore,  that  we  be  not  blamed  for 
having  made  this  arrangement. 

Hahnemann  insisted  upon  every  record  being  taken 
in  writing,  lest  symptoms  should  be  forgotten  by  the 
physician.  An  examination  instituted  by  a  homoe- 
opathic physician  is  much  more  minute  than  an 
examination  instituted  by  an  allopath ;  this  one 
neglects  to  take  cognizance  of  various  exciting  causes 
which  require  the  administration  of  peculiar  specifics 
in  homoeopathic  practice. 

"  §  83.  This  examination  of  a  particular  case  of 
disease,  (says  Hahnemann,*)  with  the  intent  of  present- 
ing it  in  its  formal  state  and  individuality,  only 
demands,  on  the  part  of  the  physician,  an  unprejudiced 
mind,  sound  understanding,  attention  and  fidelity  in 
observing  and  tracing  the  image  of  the  disease.  I 
will  content  'myself,  in  the  present  instance,  with 
merely  explaining  the  general  principles  of  the  course 
that  is  to  be  pursued,  leaving  it  to  the  physician  to 
select  those  remedies  which  are  applicable  to  each 
particular  case. 

"  §  84.  The  patient  details  his  sufferings  ;  the  persons 
who  are  about  him  relate  what  he  has  complained  of, 
how  he  has  behaved  himself,  and  all  that  they  have 
remarked  in  him.  The  physician  sees,  hears,  and 
observes,  with  his  other  senses,  whatever  there  is 
changed  or  extraordinary  in  the  patient.  He  writes 
all  this  down  in  the  very  words  which  the  latter,  and 
the  persons  around  him,  made  use  of.  He  permits 

From  the  American  edition  of  Hahncmann's  Organon. 


INTRODUCTION.  33 

them  to  continue  speaking  to  the  end  without  inter- 
ruption,* except  where  they  wander  into  useless 
digressions,  taking  care  to  exhort  them,  at  the  com- 
mencement, to  speak  slowly,  that  he  may  be  enabled 
to  follow  them  in  taking  down  whatever  he  deems 
necessary. 

"  *  Every  interruption  breaks  the  chain  of  ideas  of  the  person  who  speaks, 
and  things  do  not  afterwards  return  to  his  memory  hi  the  same  shape  he 
would  at  first  have  described  them. 

"  §  85.  At  each  new  circumstance  related  by  the 
patient  or  the  persons  present,  the  physician  commences 
another  line,  in  order  that  the  symptoms  may  all 
be  written  down  separately,  and  stand  one  beneath  the 
other.  By  this  mode  of  proceeding,  he  will  be  enabled 
to  add  to  that  which  has,  in  the  first  instance,  been  re- 
lated to  him  in  a  vague  manner,  any  thing  he  may 
subsequently  acquire  from  a  more  accurate  knowledge 
of  the  case. 

"  §  86.  When  the  patient  and  those  about  him  have 
finished  all  they  had  to  say,  the  physician  then  asks 
for  more  precise  information  with  regard  to  each  indi- 
vidual symptom,  and  proceeds  as  follows  : — He  reads 
over  all  that  has  been  communicated  to  him,  and  asks 
at  each  particular  symptom,  for  example — At  what 
epoch  did  this  or  that  circumstance  occur  ?  Was  it 
previous  to  the  use  of  the  medicines  which  the  patient 
has  taken  till  the  present  time,  or  while  he  was  taking 
them,  or  only  a  few  days  after  he  had  discontinued 
their  use  ?  What  kind  of  pain,  what  particular  sensa- 
tion was  it  that  was  felt  in  such  or  such  a  part  of  the 
body  ?  Which  the  precise  spot  that  it  occupied  ? 
Did  the  pain  come  on  in  separate  attacks  at  intervals, 
or  was  it  lasting  and  uninterrupted  ?  How  long  did 
it  continue  ?  At  what  hour  of  the  day  or  night,  and  in 
what  part  of  the  body,  was  it  most  violent,  or  where 
and  when  did  it  cease  entirely  ?  What  was  the 
precise  nature  of  this  or  that  particular  circumstance 
or  symptom  ? 

"  §  87.  Thus  the  physician  causes  all  the  indications 
which  were  given  in  the  first  instance  to  be  described 
to  him  more  closelv,  without  ever  appearing,  bv  his 
2* 


d  INTRODUCTION. 

manner  of  putting  the  question,  to  dictate  the  answer,* 
or  place  the  patient  in  such  a  position  that  he  shall 
have  nothing  to  reply  but  yes  or  no  to  his  question. 
To  act  otherwise  would  only  lead  the  person  interro- 
gated to  deny  or  affirm  a  thing  that  is  false,  or  only 
half  true,  or  even  wholly  different  from  that  which  has 
really  occurred,  according  as  it  may  suit  his  conveni- 
ence, or  for  the  purpose  of  gratifying  the  physician. 
An  unfaithful  description  of  the  disease  would  then 
result,  and,  consequently,  an  inappropriate  choice  of 
the  curative  remedy. 

"  *  For  instance,  the  physician  ought  never  to  say — '  Did  not  such  or  such 
a  thing  take  place  in  this  manner  ? '  By  giving  this  turn  to  his  questions, 
he  puts  a  false  reply  into  the  mouth  of  the  patient,  and  draws  from  him  a 
wrong  indication. 

"  §  88.  If  in  this  spontaneous  narrative  no  mention 
is  made  of  several  parts  or  functions  of  the  body,  and 
of  the  state  of  mind  of  the  patient,  the  physician  may 
then  ask  if  there  is  not  something  more  to  be  said  re- 
specting this  or  that  particular  part  or  function,  or 
relative  to  the  disposition  and  state  of  mind,f  taking 
care,  at  the  same  time,  to  confine  himself  to  general 
terms,  in  order  that  the  person  who  furnishes  the  ex- 
planation may,  thereby,  be  constrained  to  answer 
categorically  upon  these  various  points. 

"  t  For  example — Has  the  patient  had  an  evacuation  from  his  bowels  ? 
How  does  he  pass  water — freely  or  otherwise  ?  How  does  he  rest  by  day 
and  by  night?  What  is  the  state  of  mind  and  temper  of  the  patient?  Is 
he  thirsty?  What  kind  of  taste  has  he  in  the  mouth  ?  What  kinds  of 
food  and  drink  are  most  agreeable  to  him,  and  which  are  those  he  dis- 
likes ?  Do  the  different  articles  taste  as  usual,  or  have  they  another  taste 
that  is  wholly  different  ?  How  does  he  feel  after  meals?  Have  you  any 
thing  more  to  tell  me  relative  to  the  head,  belly,  or  limbs  ? 

"  §  89.  When  the  patient  (for  it  is  to  him  we  are  to 
refer,  in  preference,  for  every  thing  that  relates  to  the 
sensations  he  experiences,  except  in  diseases  where 
concealment  is  observed)  has  thus  personally  given 
the  necessary  details  to  the  physician,  and  furnished 
him  with  a  tolerable  image  of  the  malady,  the  latter 
is  then  at  liberty  to  question  him  more  specifically  if 


INTRODUCTION.  35 

he   finds   he  is  not  yet  sufficiently  informed  on  the 
subject.* 

"  For  example — How  often  have  the  bowels  been  evacuated,  and  what 
•was  the  nature  of  the  discharges?  Did  the  whitish  discharges 
consist  of  mucus  or  feces?  Were  they  painful  or  otherwise?  What 
was  the  precise  nature  of  these  pains,  and  in  what  part  were  they  felt  ? 
What  did  the  patient  throw  up?  Is  the  bad  taste  in  the  mouth  putrid, 
bitter  or  acid,  or  what  kind  of  taste  is  it?  Does  he  experience  this  taste 
before,  during,  or  after  eating  or  drinking  ?  At  what  part  of  the  day  does 
he  feel  it  in  particular  ?  What  kind  of  taste  was  connected  with  the 
eructation  ?  Is  the  urine  turbid  at  first,  or  does  it  only  become  so  after 
standing  a  while  ?  Of  what  colour  was  it  at  the  time  of  emission  ?  What 
was  the  colour  of  the  sediment  ?  Is  there  any  peculiarity  in  the  state  of 
the  patient  when  he  sleeps?  Does  he  sigh,  moan,  speak,  or  cry  out? 
Does  he  start  in  his  sleep  ?  Does  he  snore  in  inspiration  or  expiration  ? 
Does  he  lie  on  his  back  only,  or  on  which  side  does  he  lay  himself?  Does 
he  cover  himself  up  close,  or  does  he  throw  off  the  bed-covering?  Does  he 
easily-  awake,  or  does  he  sleep  too  soundly  ?  How  does  he  feel  on  waking  ? 
How  often  does  this  or  that  symptom  occur,  and  on  what  occasion?  Is  it 
when  the  patient  is  sitting  up,  lying  down,  standing  up,  or  when  he  is 
moving  about  ?  Does  it  come  on  merely  when  he  has  been  fasting,  or  at 
least  early  in  the  morning,  or  simply  in  the  evening,  or  only  after  meals,  or 
if  at  other  times,  when  ?  When  did  the  shivering  come  on  ?  Was  it 
merely  a  sensation  of  cold,  or  was  he  actually  cold  at  the  time  ?  In  what 
part  of  the  body  did  the  patient  feel  cold  ?  Was  his  skin  warm  when  he 
complained  of  being  cold?  Did  he  experience  a  sensation  of  cold  without 
shivering?  Did  he  feel  heat,  without  the  face  being  flushed?  What 
parts  of  his  body  were  warm  to  the  touch  ?  Did  the  patient  complain  of 
heat  without  his  skin  being  warm  ?  How  long  did  the  sensation  of  cold,  or 
that  of  heat,  continue  ?  When  did  the  thirst  come  on  ?  During  the  cold 
or  heat  ?  Or  was  it  before  or  after  ?  How  intense  was  the  thirst  ?  What 
did  the  patient  ask  for  to  drink  ?  When  did  the  perspiration  come  on  ? 
Was  it  at  the  commencement  or  at  the  expiration  of  the  heat  ?  What 
space  of  time  elapsed  between  the  heat  and  the  perspiration?  Was  it 
when  sleeping  or  waking  that  it  manifested  itself?  Was  it  strong  or  other- 
wise? Was  the  perspiration  hot  or  cold?  In  what  parts  of  the  body  did 
it  break  out  ?  How  did  it  smell  ?  What  did  the  patient  complain  of 
"before  or  during  the  cold,  during  or  after  the  heat,  during  or  after  the  per- 
spiration, &c.  ? 

"  §  90.  All  the  answers  being  committed  to  writing, 
the  physician  then  notes  down  what  he  himself 
observes  in  the  patient,f  and  endeavours  to  ascertain 
if  that  which  he  observes  existed  or  not  when  the  latter 
was  in  health. 

*  Nothing  is  more  unpleasant  for  a  physician,  than  an  incomplete  or 
even  incorrect  image  of  the  disease.  If  he  have  an  incorrect  impression  of 
the  disease  in  the  beginning  of  the  treatment,  he  will  find  it  difficult  to 
correct  that  impression  while  the  treatment  is  going  on.  He  will  never  be 
able  to  select  the  proper  remedy  for  the  disease,  and  his  treatment  will 
necessarily  fail — HARTMANJT. 


36  INTRODUCTION. 

"  t  For  example — How  he  behaved  during  the  time  of  the  visit.  Was  he, 
irritable,  peevish,  quarrelsome,  hasty,  grieved,  anxious,  despairing,  sad 
calm,  or  resigned?  Did  he  appear  overcome  with  sleep,  or  lost  in  reverie? 
Was  he  hoarse  ?  Did  he  speak  low  ?  Was  his  discourse  incoherent,  or 
how  was  it  ?  Of  what  colour  was  the  countenance,  the  eyes,  and  the  skin, 
generally  ?  What  degree  of  vivacity  was  there  visible  in  the  face  and 
eyes  ?  How  was  the  tongue,  the  respiration,  the  smell  from  the  mouth, 
or  the  hearing  ?  Were  the  pupils  of  the  eyes  dilated  or  contracted  ? 
Did  they  contract  and  dilate  quickly  in  light  and  darkness,  and  in  what 
degree  ?  What  was  the  state  of  the  pulse  ?  *  What  was  the  condition  of 
the  abdomen?  Was  the  skin  moist  and  warm,  cold  or  dry,  upon  this  or 
that  part  of  the  body,  or  was  it  so  all  over  ?  Did  the  patient  lie  with  his 
head  thrown  back,  with  his  mouth  wholly  or  half  open,  with  his  arms 
crossed  above  his  head  ;  was  he  on  his  back,  or  in  what  position  was  he  ? 
Did  he  raise  himself  with  difficulty  ?  In  short  the  physician  is  to  keep 
notes  of  every  thing  he  has  observed  that  is  strange  and  remarkable." 

After  having  taken  down  an  exact  record  of  the 
symptoms  of  a  case,  it  is  essential  to  investigate  the 
causa  occasionalis,  be  it  a  permanently  existing,  mate- 
rial or  an  immaterial,  dynamic  cause,  having  ceased  to 
be  present.  We  further  require  to  consider  the  business 
of  the  patient  (whether  the  disease  be  occasioned  by 
it),  his  moral  disposition,  mode  of  life.  We  ought  to 
inquire  whether  the  patient  is  moderate  in  eating  and 
drinking,  in  his  amusements,  or  whether  he  has  im- 
posed upon  himself  hurtful  privations?  whether  he 
has  injured  himself  by  venereal  excesses  ?  We  have 
further  to  ascertain  whether  disappointed  love, 
jealousy,  domestic  quarrels,  chagrin,  grief,  abusive 
treatment,  suppressed  vengeance,  humbled  pride,  loss 
of  property,  etc.,  have  been  instrumental  in  occasion- 
ing the  disease  ? 

A  correct  knowledge  of  the  hereditary  disposition, 
age  and  temperament  of  the  patient  is  likewise  of 
great  importance.  If  the  patient  be  a  female,  the 
physician  has  to  inquire  into  the  condition  of  the 
menses,  whether  the  menstrual  period  is  too  long  or 
too  short,  how  many  days  the  menses  flow,  whether 
they  flow  uninterruptedly  or  at  intervals,  whether  they 
are  copious  or  scanty,  of  what  colour,  whether  they 


*  The  physician  examines  the  pulse,  the  condition  of  the  heart,  whether  it 
beats  normally  or  abnormally,  the  chest,  the  abdomen,  and  does  not  neglect 
any  of  the  manipulations  or  instruments  by  means  of  which  the  internal  phe- 
nomena of  the  disease  are  more  or  less  correctly  ascertained. — HARTMAXX. 


INTRODUCTION.  37 

are  accompanied,  preceded  or  succeeded  by  leucor- 
rhoea?  Whether  they  are  accompanied  \vith  moral 
or  physical  sufferings,  and  what  are  the  peculiar  pains 
and  sensations  which  manifest  themselves  before, 
during,  or  after  the  appearance  of  the  menses  ?  What 
is  the  appearance  of  the  leucorrhoeal  discharge,  with 
what  sensations  it  is  accompanied,  whether  it  is 
abundant  or  scanty,  and  under  what  circumstances  or 
by  what  causes  it  is  especially  excited  ?  Whether  the 
patient  is  sterile,  or  whether  she  has  been  pregnant 
and  how  often  ?  Whether  she  has  miscarried  ?  What 
was  the  condition  of  her  breasts,  milk,  etc.  ?  What  is 
the  strength  of  her  sexual  desire?  In  diseases  of 
the  sexual  organs  the  physician  ought  always  to  in- 
stitute an  examination  of  the  parts  both  internal  and 
external. 

Inquiry  ought  to  be  made  about  the  diseases  with 
which  the  patient  may  have  been  afflicted  previously, 
both  in  acute  and  chronic  diseases,  especially,  how- 
ever, in  the  latter,  with  a  view  of  ascertaining  whether 
preceding  diseases  have  led  to  the  present  malady,  or 
to  what  an  extent  they  complicate  it.  An  inquiry 
into  the  previous  diseases  of  the  patient  sometimes 
leads  us  to  a  correct  knowledge  of  the  disease  in 
chronic  cases,  and  even  helps  us  in  selecting  the 
remedies  which  we  ought  to  use  in  the  treatment  of 
those  cases.  Although  we  do  not  admit  that  seven- 
eighths  of  all  chronic  diseases  owe  their  existence  to 
the  psoric  miasm,  yet  it  is  undoubtedly  true  that  the 
suppression  of  a  previous  cutaneous  eruption,  scabies, 
herpes,  tineat  scrophulosis,  etc.  induces  a  vast  number 
of  chronic  diseases  which  make  their  appearance 
shortly  after  the  eruption  had  been  suppressed,  the  as- 
sertions of  many  great  doctors  to  the  contrary  not- 
withstanding, who  pretend  that  the  itch  is  a  mere 
external  disease  which  is  caused  by  the  acarus  and  can 
be  cured  by  simply  destroying  that  insect  by  any,  even 
mechanical  means.  The  homeopathic  physician  can- 
not accept  such  theories,  although  he  may,  on  the  other 
hand,  feel  justified  in  believing  that  Hahnemann  goes 
too  far  in  considering  the  psoric  miasm  as  a  morbific 


38  INTRODUCTION. 

principle  which  is  coeval  with  mankind  and  has  affected 
more  or  less  every  organism.  One  thing  is  certain,  the 
influence  which  previous  diseases  may  have  upon  the 
present  one,  has  to  be  carefully  investigated. 

If,  in  examining  a  patient,  the  physician  should  dis- 
c'over  symptoms  pointing  to  the  use  of  a  .certain  drug 
which  is  frequently  employed  in  domestic  and  allo- 
pathic practice,  it  is  the  physician's  duty  to  inquire 
whether  large  doses  of  that  drug  have  not  already 
been  taken.  Such  drugs  are  :  Valerian,  Chamomile, 
Mercurius,  and  mercurial  preparations  used  either  in- 
ternally or  externally,  Iodine  and  Iodine  ointment, 
Sulphur,  Opium,  China  and  Quinine,  Digitalis,  Prussic 
acid,  Cathartics,  etc. 

If  any,  especially  an  acute  disease  should  prevail, 
its  character  or  genius  requires  to  be  noticed  with 
care,  inasmuch  as  it  will  influence  more  or  less  the 
character  of  the  disease  which  we  are  called  upon  to 
treat  and  may  be  a  clue  to  the  practitioner  for  the 
selection  of  the  adequate  remedial  agent. 

To  institute  in  every,  even  trivial  case,  such  a  rigor- 
ous examination  as  has  been  here  described,  would 
involve  a  useless  loss  of  time  and  would  be  very 
fatiguing  to  the  patient.  Our  intention  has  simply 
been  to  state  what  sort  of  an  examination  should  be 
made  in  a  complicated  case,  leaving  it  to  the  intelli- 
gent and  conscientious  physician  to  condense  the  ex- 
amination as  much  as  a  judicious  appreciation  of  the 
case  by  means  of  his  physiological,  pathological  and 
therapeutic  knowledge  will  permit.  A  carefully  in- 
stituted examination  is  the  touchstone  of  a  true  artist 
in  homoeopathic  practice. 

This  is  perliaps  the  best  place  to  say  a  few  words 
about  the 


CLASSIFICATION    OF    DISEASES. 

A  classification  of  diseases  has  not  so  much  value 
in  reference  to  therapeutics  as  to  the  investigation  of 
the  character  of  the  disease. 


INTRODUCTION.  39 

We  may  divide  diseases  in  reference  to  the  individ- 
uality of  the  patients  into 

(a.)  Diseases  belonging  to  peculiar  ages  (morbi 
Eetatum),  which  may  be  either  acute  or  chronic. 
Owing  to  the  extreme  irritability  of  the  childish  organ- 
ism, it  is  peculiarly  liable  to  spasmodic  sufferings  ;  the 
reproductive  system  being  principally  active  in  the 
child,  it  must  be  subject  to  diseases  which  are  princi- 
pally seated  in  the  lymphatics  ;  the  disturbances  which 
occur  in  the  reproductive  system,  maintained  and  in- 
creased by  the  want  of  irritability  and  by  the  inac- 
tivity of  the  lymphatics,  are  characterized  by  con- 
gestion to  the  brain  in  the  form  of  epistaxis,  meningitis, 
hydrocephalus,  typhoid  symptoms  of  various  kinds, 
scrophulosis,  helminthiasis,  etc.  In  a  more  advanced 
age,  when  the  vitality  of  the  thoracic  organs  is  de- 
veloped in  a  superior  degree,  congestion  of  the 
lungs  is  a  prevalent  condition,  inducing  a  correspond- 
ing predisposition  to  pulmonary  diseases  ;  in  this  age 
the  sexual  organs  develope  themselves  and  the  pas- 
sions connected  with  that  development  begin  to  be  felt, 
and,  if  satisfied  to  excess,  lead  to  various  diseases 
peculiar  to  this  second  period  of  life.  The  smallest 
number  of  diseases  occurs  in  the  period  when  the 
human  organism  is  fully  and  harmoniously  developed. 
As  man  advances  in  age,  the  abdominal  organs  are 
principally  affected,  hence  atony  of  the  intestinal 
canal,  hypochondria,  haemorrhoids,  gout,  etc.  are  the 
principal  diseases  of  that  period.  Old  age,  when  all 
the  moral  and  physical  energies  of  man  are  on  the 
decline,  is  especially  predisposed  to  paralysis  of  every 
kind,  deafness,  blindness,  apoplexy,  asthma,  paralysis 
of  the  lungs,  affections  of  the  bladder,  etc.  Diseases 
affecting  the  organism  during  a  transition  period 
(which  may  be  said  to  occur  every  seventh  year,)  are 
of  a  higher  importance  on  account  of  the  development 
which  the  organs  undergo  during  that  period. 

(b.)  Diseases  belonging  to  the  different  sexes  (morbi 
sexus).  The  difference  which  prevails  in  the  charac- 
ter and  degree  of  the  irritability,  sensibility  and  re- 
production of  the  female  and  the  male  organism  and 


40  INTRODUCTION. 

in  the  physical  as  well  as  psychical  tendencies  of  the 
two  sexes,  makes  each  of  them  liable  to  peculiar  dis- 
eases. Suffice  it  to  mention  the  various  nervous  dis- 
eases to  which  women  are  subject ;  the  diseases 
depending  upon  the  peculiar  sensitiveness  and  irrita- 
bility of  the  female  temperament ;  the  various  diseases 
affecting  the  reproductive  system  of  the  female  organ- 
ism, such  as  tuberculosis,  carcinoma,  scirrhus,  etc. 

(c.)  Diseases  belonging  to  particular  classes  and 
trades.  Rich  people,  who  are  accustomed  to  rich  and 
luxurious  living  and  spend  their  life  in  idleness  and 
ennui,  are  liable  to  derangements  of  the  abdominal 
organs  and  consecutive  diseases,  such  as  gout  etc., 
whereas  the  poor  are  affected  with  diseases  result- 
ing from  an  impoverished  reproduction.  Tanners  are 
subject  to  dropsies ;  type-founders,  miners,  potters  to 
tabes  metallica ;  tailors  and  workers  in  wool  to 
scabies  ;  compositors  and  printers  to  cedema  of  the 
feet  and  varicose  conditions ;  chimney-sweeps  to 
gangrene  of  the  genital  organs ;  stone-cutters,  hair- 
dressers, millers  to  pulmonary  phthisis  ;  washerwomen 
to  dropsy  ;  literary  men  who  lead  a  sedentary  life,  to 
diseases  of  the  abdominal  organs  ;  mariners  and  fish- 
ermen to  scurvy,  anasarca,  etc. 

What  has  been  said  in  the  preceding  paragraphs,  is 
sufficient  to  show  all  the  essential  points  which  the 
physician  ought  to  be  informed  about  in  order  to  ob- 
tain a  correct  knowledge  of  the  origin  and  course  of 
the  disease,  and  even  the  internal  changes  which  char- 
acterize it ;  that  knowledge  being  indispensable  to  a 
sure  and  successful  treatment. 

Diseases  may  also  be  classed  according  to  the 
region  over  which  they  spread.  We  have 

(a.)  Sporadic  (morbi  sporadici),  or  diseases  which 
depend  upon  meteoric  or  telluric  miasmata  and  affect 
only  single  individuals  who  happen  to  be  predisposed 
for  such  diseases  at  the  time  when  they  are  prevalent ; 

(b.)  Endemic  (morbi  endemici).  These  diseases  are 
confined  to  a  definite  and  often  very  limited  region  ; 
they  are  distinguished  from  the  former  by  being  de- 


INTRODUCTION.  41 

pendent  upon  the  situation  of  a  place  and  its  sur- 
rounding region,  upon  the  climate,  the  condition  of  the 
atmosphere,  winds,  soil  and  water,  upon  the  mode  of 
life  of  the  inhabitants,  food,  social  life.  Every  place 
may  therefore  have  diseases  which  are  peculiar  to  it ; 
it  is  a  remarkable  fact  that  apparently  identical  dis- 
eases which  prevail  in  places  not  very  distant  from 
one  another,  require  the  application  of  different  reme- 
dies in  the  different  places. 

(c.)  Epidemic  (morbi  epidemici).  These  diseases 
are  closely  related  to  the  former,  with  this  difference, 
that  they  prevail  at  periods  in  a  greater  or  lesser  ex- 
tent of  country,  and  affect  all  ages  and  sexes  indis- 
criminately ;  they  depend  upon  a  cause  of  atmospheric 
or  cosmic  origin,  generally  upon  a  miasm  which  be- 
comes contagious  among  crowded  masses  and  then 
spreads  so  much  more  rapidly  and  over  a  larger 
surface. 

(d.)  Morbi  annui.  These  are  diseases  which  pre- 
vail at  particular  periods  of  the  year,  in  the  spring, 
summer,  fall*or  winter.  In  the  winter  inflammatory 
diseases  are  prevalent,  whereas  the  prevalent  diseases 
in  spring  are  rather  of  a  catarrhal  nature.  The  fall 
diseases  are  characterized  by  gastric-pituitous  symp- 
toms, and  those  of  the  summer-season  have  moreover 
a  typhoid  character.  This  class  of  diseases  is  evidently 
affected  by  sudden  changes  in  the  weather. 

(e.)  Morbi  stationarii.  It  is  of  great  importance  to 
a  physician  to  know  what  peculiar  character  a  dis- 
ease is  disposed  to  assume  in  a  place.  This  topical 
influence  modifies  the  character  of  the  above-men- 
tioned diseases  more  or  less.  It  prevails  during  a 
shorter  or  longer  number  of  years,  abates  gradually, 
finally  disappears  entirely  and  returns  after  an  in- 
definite period. 

(f.)  Morbi  intercurrentes.  These  are  diseases  which 
depend  upon  causes  entirely  different  from  those  that 
occasion  the  prevailing  disease ;  but  they  frequently 
ingraft  their  character  upon  the  latter,  and,  by  so 
doing,  are  apt  to  transform  a  naturally  mild  disease 
into  a  dangerous  and  malignant  one. 


42  INTRODUCTION. 

To  this  classification  of  diseases  we  shall  add  a  few 
indications  which  are  of  great  use  in  examining  a 
patient.  In  investigating  the  symptoms  of  an  epi- 
demic or  sporadic  disease,  it  makes  no  sort  of  differ- 
ence whether  a  similar  disease  has  existed  previously. 
The  previous  disease  has  no  sort  of  influence  upon  the 
present  epidemic,  which  requires  to  be  thoroughly  in- 
vestigated as  an  entirely  new,  unknown  disease  of  a 
peculiar  kind.  Hahnemann  teaches  that  even  measles, 
smallpox,  scarlatina,  rubeola,  etc.  are  not  exempt  from 
that  rule ;  these  diseases  depend,  it  is  true,  upon  the 
same  miasm,  but  the  form  of  the  eruption  only  re- 
mains the  same.  In  all  those  diseases  there  is  an 
essential  difference  as  regards  the  systems  which  are 
principally  affected,  the  concomitant  symptoms,  the 
prognosis,  and  the  course  and  termination  of  the  disease. 

The  physician  frequently  requires  to  investigate  two 
or  three  cases  of  an  epidemic  disease  before  he  suc- 
ceeds in  obtaining  a  correct  idea  of  the  totality  of  the 
characteristic  symptoms  which  scarcely  ever  exist  to- 
gether in  one  case  ;  but  even  an  incomplete  know- 
ledge of  those  symptoms  will  enable  him  to  administer 
a  remedy  with  more  certainty  than  an  allopathic 
physician  could  do.  However,  although  he  may  feel 
sure  that  he  has  given  a  remedy  which  corresponds  as 
nearly  as  possible  to  the  symptoms  so  far  as  he  knows 
them,  yet  he  ought  to  make  it  his  duty  to  observe 
every  new  case  with  the  same  unremitting  attention, 
in  order  to  finally  complete  his  group  of  the  character- 
istic symptoms  of  the  disease  and  to  be  sure  that  he 
has  selected  the  true  specific  remedy. 

In  thus  observing  an  epidemic  disease,  the  general 
symptoms,  such  as  loss  of  appetite,  want  of  sleep, 
eructations,  etc.,  will  be  specially  and  correctly  noticed, 
and  the  characteristic  particular  symptoms  of  the 
epidemic  disease  will  be  found  to  constitute  a  limited 
and  rarely-occurring  group.  These  symptoms  all 
originate  in  the  same  cause,  but  their  totality  can  only 
be  known  by  observing  several  patients  of  different 
constitutions  and  temperaments.*. 

*  See  Organon,  §  100-102. 


INTRODUCTION.  43 

Stationary  diseases  likewise  require  a  correct  and 
thorough  investigation  of  all  the  symptoms  which  can 
only  be  known  by  observing  a  number  of  patients  and 
we  will  often  find  that  the  whole  group  of  symptoms 
indicates  a  different  remedy  from  what  we  might  have 
selected  after  a  merely  superficial  investigation  of  the 
disease.  This  scrupulous  investigation  is  of  essential 
benefit  in  intercurrent  diseases,  where  the  character- 
istic symptoms  frequently  point  to  the  same  remedy 
which  corresponds  to  the  symptoms  of  the  stationary 
diseases  in  that  region. 

According  to  their  origin,  diseases  may  be  divided  into 

(a.)  Hereditary  (morbi  hereditarii).  These  are  dis- 
eases which  have  existed  in  a  family  for  generations 
past.  We  have  an  hereditary  scrofulous,  haemorrhoid- 
al,  phthisical,  apoplectic,  etc.  disposition,  which  deve- 
lopes  itself  in  spite  of  the  utmost  care  in  removing  all 
hurtful  influences,  and  frequently  leads  to  the  dissolu- 
tion of  the  organism,  baffling  the  best  directed  efforts 
of  the  physician. 

If  the  physician  should  have  reasons  to  suspect  the 
existence  of  an  hereditary  disposition,  he  ought  to  in- 
quire whether  any  of  the  ancestors,  parents,  brothers, 
sisters  have  been  affected  with  a  similar  disease,  or 
have  died  with  it.  If  this  should  be  so,  he  will  be 
much  better  able  to  express  a  correct  opinion  in  regard 
to  the  prognosis  and  to  the  chances  of  a  cure. 

(b.)  Morbi  congeniti.  These  diseases  generally  de- 
pend upon  malformations  with  which  the  individual 
was  born. 

(c.)  Morbi  acquisiti.  These  are  diseases  for  which 
the  patient  had  no  particular  predisposition,  but  which 
he  brought  upon  himself  by  exposing  himself  for  a 
length  of  time  to  hurtful  influences,  for  example: 
taking  hurtful  beverages  and  nourishment,  indulging 
excesses  of  various  kinds  which  gradually  undermine 
health,  being  constantly  deprived  of  the  necessary 
means  of  subsistence,  living  in  unwholesome,  marshy 
regions,  or  in  cellars  and  close  apartments,  being  de- 
prived of  exercise  or  open  air,  indulging  excessive 


44  INTRODUCTION. 

physical  or  mental  exertions,  being  continually  agi- 
tated by  unpleasant  moral  emotions,  etc. 

No  psoric  miasm  is  required  to  develope  such  dis- 
eases. According  to  Hahnemann  such  diseases  dis- 
appear of  themselves  if  they  have  not  excited  a 
chronic  miasm. 

(d.)  Primary  .diseases  (morbi  primarii,  protopathici). 
These  are  diseases  which  result  immediately  from 
noxious  influences,  whereas  the  secondary,  consecutive 
diseases  (morbi  secundarii,  deuteropathici,)  arise  from 
a  malady  which  is  already  existing.  This  class  of 
diseases  requires  no  special  definition,  as  their  name 
indicates  their  character. 

(e.)  Contagious  and  miasmatic,  and  non-contagious 
and  non-miasmatic  diseases.  A  contagium,  whether  it 
be  originally  formed  in  man  or  in  any  other  kind  of 
organic  body,  in  animals  or  plants,  is  a  material  sub- 
stance, the  original  and  exclusive  product  of  a  morbid 
condition  of  the  organism  and  possessing  the  power  of 
infecting  other  individuals  of  the  same  kind  with  an 
identical  or  at  least  very  similar  disease  and  of 
spreading  in  this  way  to  remote  regions.  A  contagium 
being  dependent  upon  meteoric  and  telluric  influences, 
it  is  most  easily  developed  in  times  of  Avar,  famine 
and  inundation,  producing  hospital,  dungeon  and  yel- 
low fever,  typhus,  etc. 

A  miasm,  on  the  contrary,  is  a  volatile  deleterious 
substance,  the  chemical  composition  of  which  is  un- 
known, which  spreads  through  the  atmosphere  and 
incorporates  itself  with  it  with  more  or  less  tenacity. 
A  miasm  frequently  arises  from  decayed  organized 
bodies  and  from  the  exhalations  of  sick  persons. 
People  who  are  forced  to  live  in  such  a  deleterious 
atmosphere,  are  necessarily  exposed  to  its  influence. 
Considering  the  multitude  of  vitiated  exhalations 
which  are  concentrated  in  many  places  where  people 
have  to  live,  it  cannot  appear  strange  that  the  number 
of  miasmatic  diseases  should  be  very  considerable. 
Miasm  and  contagium  frequently  go  hand  in  hand,  one 
producing  the  other,  as  is  the  case  in  smallpox. 


INTRODUCTION.  45 

The  division  of  diseases  into  local  and  constitutional 
is  without  any  practical  value.  Every  physician 
knows  that  the  so-called  local  diseases  are  much  more 
speedily  removed  by  internal  remedies  than  by  exter- 
nal applications  ;  we  need  but  remind  the  reader  of 
syphilis,  sycosis,  plica  polonica,  etc.  The  fearful  dis- 
eases which  frequently  break  out  after  the  pretended 
local  affection  had  been  suppressed  by  external  means, 
show  that  this  apparently  local  symptom  was  a  sort 
of  vicarious  concentration  of  the  internal  constitu- 
tional disease  which  was  held  in  a  latent  state  as  long 
ae  the  local  symptom  continued  upon  the  skin.  How 
is  it  possible  that  a  simple  ulcer  on  the  finger  should 
not  only  remain  uncured  under  the  merely  external 
surgical  treatment,  but  that  it  should  even  assume  the 
dangerous  form  of  a  phagedenic  ulcer,  if  it  were  not 
the  local  vicarious  expression  for  an  internal  dyscrasia. 
It  is  self-evident  that  an  apparently  local  affection 
which  does  not  owe  its  existence  to  an  external  cause, 
must  depend  upon  a  coexisting  disturbance  of  various 
organs  and  tissues  ;  the  local  affection,  even  if  it  had 
been  produced  by  a  merely  local  external  cause,  can- 
not exist  for  any  length  of  time  without  affecting  the 
whole  organism,  as  we  see  in  the  case  of  a  burn,  a 
toothache  proceeding  from  a  carious  tooth,  etc. 

The  division  of  diseases  into  acute  and  chronic  is  of 
particular  importance  to  us,  for  this  reason,  that  we 
have  made  that  division  the  basis  of  the  arrangement 
which  we  have  adopted  in  the  present  work.  To 
each  of  those  divisions  we  have  devoted  a  special 
volume. 

Acute  diseases  are  sudden  disturbances  of  the  vital 
force,  characterized  by  the  greater  rapidity  with 
which  they  run  through  their  course  and  by  the 
powerful  reaction  which  takes  place  in  the  vascular 
system.  In  treating  such  diseases,  it  is  a  matter  of 
course  that  wherever  wre  know  the  cause  from  which 
they  arise  we  ought  to  remove  it  if  we  can. 

Chronic  maladies  frequently  arise  from  a  disturb- 
ance of  the  vital  force,  which  is  seated  in  the  vegeta- 


46  INTRODUCTION. 

tive  system.  A  concealed  dyscrasia  affecting  that 
system  is  frequently  the  cause  of  the  obstinacy  with 
which  those  diseases  cling  to  the  organism.  Accord- 
ing to  Hahnemann,  chronic  diseases  invade  the  organ- 
ism, each  in  its  own  peculiar  manner,  the  invasion 
being  scarcely  or  not  at  all  perceived,  in  the  com- 
mencement and  gradually  overpowering  the  vital 
force,  so  that  it  is  only  able  to  offer  an  inadequate  re- 
sistance, allowing  the  malady  to  increase,  until  it 
finally  destroys  the  organism.  Starting  from  the  de- 
finitions \vhich  we  have  given  of  acute  and  chronic 
diseases,  it  will  be  found  easy  to  draw  a  line  of  separa- 
tion between  them,  especially  if  we  admit  Hahne- 
mann's  theory  that  all  chronic  diseases  derive  their 
existence  from  some  miasm ;  a  theory,  which  seems  to 
be  somewhat  inconsistent  with  Hahnemann's  previous 
condemnation  and  rejection  of  all  theories  and  specu- 
lations about  the  essence  of  disease  and  the  rela- 
tion existing  between  it  and  the  changes  in  the  body. 
We  have  already  stated  above  that  a  number  of  dis- 
eases may  exist  without  depending  upon  a  psoric 
miasm,  and  Hahnemann  seems  to  have  had  a  similar 
idea  inasmuch  as  he  designates  them  spurious  or  im- 
proper chronic  diseases.  He  accepted  three  funda- 
mental forms  of  chronic  diseases  :  psora,  syphilis  and 
sycosis  ;  from  these  three  fundamental  chronic  miasms 
all  chronic  diseases  derive  their  origin,  seven-eighths 
from  the  former,  and  the  remaining  eighth  from  the 
two  latter.  It  is  neither  our  intention,  nor  is  this  the 
proper  place  to  criticize  Hahnemann's  views  ;  we  may 
however  remark  that  the  merely  palliative  effect 
which  he  frequently  obtained  from  his  remedies  in 
chronic  diseases,  led  him  to  the  belief  that  these  dis- 
eases depended  upon  some  latent  chronic  miasm ;  and 
it  was  indeed  ascertained  that  many  of  them  had  been 
preceded  by  itch.  Hahnemann  was  persuaded  that 
the  suppressed  itch  was  the  primary  cause  of  those 
diseases.  Observing  that  several  of  them  had  been 
cured  by  the  use  of  mineral  springs,  his  acute  powers 
of  penetration  led  him  to  suppose  that  the  cure  had 
been  wrought  by  the  medicinal  substances  which 


INTRODUCTION,  47 

» 

exist  in  those  springs  in  minute  and  greatly  divided 
quantities.  He  was  confirmed  in  this  view  by  farther 
observations  and  the  successive  results  of  his  practice, 
and  he  therefore  designated  the  medicines  by  means 
of  which  the  cure  of  chronic  diseases  was  effected,  as 
antipsorics — that  is,  medicines  directed  against  a  chronic 
malady.  It  is  now  well  known,  however,  that  those 
antipsorics  not  only  cure  chronic,  but  also  a  host  of 
acute  diseases,  and  that  they  are  employed  for  that 
purpose  by  all  homoBopathic  practitioners.  Hahne- 
mann  be  praised  for  having  made  us  acquainted  with 
such  efficient  means  to  relieve  the  sufferings  of  our 
fellow-beings.  • 

It  is  an  undoubted  fact  that  the  inveterate  character 
of  chronic  diseases  frequently  depends  upon  some 
latent  dyscrasia  which  has  become  rooted  in  the 
organism,  and  that  those  conditions  have  been  re- 
moved by  certain  remedies  which  exercise  a  specific 
effect  upon  the  organs  invaded  by  a  psoric  miasm.  It 
is  for  this  reason  that  the  general  therapeutic  rules 
remain  the  same  for  chronic  as  well  as  any  other  dis- 
eases. If  such  chronic  diseases  have  already  been 
treated  with  a  variety  of  allopathic  medicinal  sub- 
stances, it  is  advisable  that  the  homo3opathic  practi- 
tioner should  let  some  time  elapse  before  he  gives  any 
medicine  to  the  patient,  that  the  organism  may  free 
itself  as  much  as  possible  from  the  various  influences 
which  those  drugs  have  left  and  may  become  more 
susceptible  to  the  action  of  our  small  doees. 

According  to  Hahnemann,  diseases  of  the  mind  like- 
wise originate.  These  diseases  do  not  constitute  as 
distinct  a  class  of  diseases  as  those  which  have  been 
indicated  above.  In  almost  every  disease  of  the  body 
the  mind  is  affected  more  or  less,  on  which  account 
the  state  of  th.e  mind  is  to  be  regarded  as  an  important 
feature  in  the  image  of  the  disease.  We  know  from 
experience  that  the  condition  of  the  mind  in  health  is 
frequently  the  contrary  of  what  it  was  in  disease.  If 
a  certain  group  of  symptoms  indicate  two  different 
remedies,  the  state  of  the  mind  is  frequently  the  only 
symptom  by  which  we  can  decide  which  of  those  reme- 


48  INTRODUCTION. 

dies  ought  to  be  selected  ;  Aconite,  for  instance,  will 
never  effect  a  rapid  cure  in  a  person  with  a  calm,  even 
temperament ;  Nux  will  be  found  very  little  adapted 
to  a  mild  and  phlegmatic,  or  Pulsatilla  to  a  cheerful, 
bright  and  obstinate  temper ;  Ignatia  is  counter-indi- 
cated by  an  unchangeable  mind  which  is  neither 
given  to  fright  nor  vehemence. 

In  all  chronic  diseases  it  is  not  only  of  the  utmost 
importance  to  investigate  all  the  physical  symptoms, 
but  the  moral  and  mental  condition  of  the  patient 
would  seem  to  require  our  especial  attention.*  The 
physician  will  have  not  only  to  inquire  into  all  the 
previous  bodily  diseases  of  the  patient,  but  he  will 
have  to  make  particular  inquiries  about  the  disease 
which  preceded  the  mental  disorder  previous  to  its  in- 
creasing to  a  complete  derangement.  This  informa- 
tion can,  of  course,  only  be  obtained  from  the  family. 
If  the  mental  derangement  (mania,  rage)  set  in  of  a 
sudden,  in  consequence  of  fright,  chagrin,  abuse  of 
spirituous  drinks,  then  Hahnemann  teaches  that  it  is  to 
be  treated  as  an  acute  disease  with  Aconite,  Bella- 
donna, Stramonium,  Hyosciamus,  Veratrum,  Mercurius, 
etc.,  and  that  the  antipsoric  treatment,  with  a  properly 
regulated  diet,  ought  to  be  instituted  only  after  the 
acute  symptoms  have  been  subdued ;  the  antipsoric 
treatment  is  necessary  to  prevent  a  new  outbreak  of 
the  disease  which  might  easily  become  a  permanent 
derangement. 

Diseases  of  the  mind  which  are  not  yet  fully  de- 
veloped and  do  not  arise  from  bodily  affections  but 
from  bad  habits,  faulty  education,  immoral  conduct, 
neglect,  superstition  or  ignorance,  may  be  improved 
by  kind  persuasion,  consolations,  romonstrance,  reason- 
ing ;  whereas  those  mental  diseases  which  arise  from 
bodily  diseases,  are  made  worse  by  such  means,  and 
become  more  inveterate.  A  physician  ought  never  to 
lose  patience  or  self-control,  he  ought  never  to  indulge 
angry  expressions  or  manners,  lest  he  should  lose  the 
confidence  and  the  affection  of  his  patients,  which  are 
indispensable  means  of  cure. 

*  See  Organon,  §  217  seq. 


IWTRODUCTIOir.  49 

There  is  another  class  of  mental  diseases  which  we 
observe  in  men  who  have  been  frequently  a  prey  to 
grief,  chagrin,  insults,  attacks  of  fear  and  fright. 
Those  diseases  emanate  primarily  from  the  mind, 
and  the  bodily  affection  is  a  mere  result  of  the 
mental  disturbance.  If  these  diseases  be  recent,  they 
are  most  easily  removed  by  spiritual  means,  such  as : 
kind  persuasion,  reasoning,  confiding  manners,  some- 
times by  a  clever  deception  ;  the  mode  of  life  ought 
not  to  be  neglected,  of  course.  Such  means  are  fre- 
quently sufficient  to  restore  the  normal  state  of  the 
mind. 

In  all  cases  of  mental  derangement  which  can  be 
cured  by  homoeopathic  remedies  it  is  essential  not  only 
to  observe  a  rigorous  diet,  but  to  submit  the  patient  to  a 
proper  treatment  on  the  part  of  his  relatives  and 
physician.  The  raving  maniac  ought  to  meet  a  firm 
will  and  a  bold  and  fearless  expression  of  countenance  ; 
the  lamenting  and  disconsolate  ought  to  be  surrounded 
with  silent  and  sympathizing  grief;  senseless  prattle 
ought  to  be  met  by  silence  expressing  a  slight  degree 
of  attention  ;  disgusting  and  revolting  conduct  are  to 
be  left  unheeded.  The  patients  ought  to  be  prevented 
from  injuring  or  ruining  the  things  around  them,  with- 
out rebuking,  or,  what  would  be  still  worse,  pun- 
ishing or  torturing  them.  The  only  compulsion  to 
which  the  patient  is  liable,  is  to  take  the  homoeopathic 
medicine,  but  even  that  kind  of  compulsion  can  be 
avoided  by  mixing  the  medicine  in  the  beverage  of  the 
patient  without  his  knowing  it. 

It  is  a  great  mistake  on  the  part  of  the  physician  or 
the  attendants  of  the  patients  to  contradict,  censure, 
or  scold  them,  or  to  treat  them  with  yielding  timidity  ; 
it  would  be  just  as  indiscreet  to  irritate  them  by  de- 
rision, and  ill-disguised  deception.  On  the  contrary, 
those  patients  ought  always  to  be  treated  like  sane 
persons,  and  everything  by  which  their  senses  or 
minds  might  be  disturbed,  ought  to  be  carefully  re- 
moved from  their  presence. 


50  INTRODUCTION. 

GENERAL  THERAPEUTIC  RULES. 

We  have  shown  above  that  the  first  essential 
requisite  of  a  cure  is,  a  thorough  investigation  of  all 
the  perceptible  symptoms  of  a  disease.  This  investi- 
gation is  so  much  more  necessary  as,  according  to 
Hahnemann,  the  symptoms  which  reflect  the  internal 
disease  in  a  visible  and  tangible  form  are  the  only 
part  of  the  disease  which  we  can  perceive  with  our 
senses  and  therefore  know.  If  the  symptoms  are  re- 
moved the  disease  no  longer  exists.  We  do  not  en- 
tirely admit  this  proposition  as  may  be  inferred  from 
our  mode  of  examining  the  patient ;  but  as  our  object 
is  not  to  remark  upon  Hahnemann's  theories,  we  have 
contented  ourselves  with  showing  the  mode  of  arriving 
at  a  correct  diagnosis  and  at  a  knowledge  of  the 
specific  means  by  which  the  disease  will  be  most  per- 
manently and  thoroughly  cured. 

We  doubt,  however,  whether  such  a  cure  is  possible 
in  every  case.  How  often  is  our  treatment  baffled  by 
disorganizations  which  have  lasted  a  sufficient  length 
of  time  to  produce  functional  disorders  and  an  exces- 
sive irritation  of  the  sensitive  sphere  ;  we  may  men- 
tion headache  depending  upon  an  exostosis  of  the  cra- 
nium ;  epilepsy,  occasioned  by  tubercles  in  the  brain ; 
dropsy,  by  organic  degenerations  ;  organic  difficulties 
about  the  heart ;  cardialgia,  and  chronic  vomiting,  de- 
pending upon  tubercles,  cysts  in  the  oesophagus,  or 
carcinoma  of  the  pyloric  orifice ;  metrorrhagia,  occa- 
sioned by  carcinoma;  haemoptysis,  from  disorganization 
of  the  lungs,  etc. :  all  such  affections  are  incurable 
under  any  treatment.  Under  this  head  belong  ex- 
haustion of  the  vital  energies  by  marasmus,  profuse 
evacuations,  excessive  exertions ;  diseases  which  set 
in  with  a  sudden  and  overpowering  violence,  such  as : 
hospital-typhus,  pest,  violent  cases  of  poisoning ;  and 
we  may  lastly  class  under  this  category  the  unavoid- 
able and  permanent  presence  of  hurtful  influences, 
such  as:  grief  from  disappointed  love,  cares,  chagrin, 
remorse,  living  in  a  climate  which  is  injurious  to  the 
patient,  etc. 

We  have  already  spoken  of  the  necessity  of  inves- 


INTRODUCTION.  .         51 

tigating  and,  if  possible,  removing,  the  exciting  cause 
of  the  disease,  and  we  here  allude  to  it  again  in  order 
to  impress  that  necessity  upon  the  minds  of  our  read- 
ers as  emphatically  as  possible.  Even  when  the^Jfe- 
citing  cause  is  no  longer  present  and  the  disease'  goes 
on  in  its  course,  we  ought  to  select  our  remedies  $dth 
reference  to  it.  To  the  examples  which  we^Jiave  fur- 
nished above  and  \vhich  were  principally  intended  to 
illustrate  the  fact  that  the  remedial  agent  ought  to  be 
selected  with  a  particular  reference  to  the  exciting 
cause,  we  subjoin  a  few  more  with  a  view  of  showing 
the  necessity  of  submitting  the  patient  to  a  particular 
diet,  avoiding  all  those  things  which,  although  the 
patient  may  have  been  in  the  constant  habit  of  using 
them,  might  injure  the  good  effects  of  the  specific 
remedy.  If  the  physician  is  at  the  same  time  the 
friend  of  his  patient — which  he  ought  to  be,  inasmuch 
as  the  physician  is  initiated  into  all  the  secret  cares 
and  difficulties  of  his  patient, — he  may  frequently  do 
more  good  by  a  kind  word,  a  consolation,  or  a  friendly 
mediation,  than  by  medicine  ;  at  any  rate,  the  medi- 
cine which  is  administered  by  the  hand  of  a  friend, 
will  do  more  good  than  a  superficial,  formal  consulta- 
tion. In  some  cases  the  cure  may  be  facilitated  by 
transferring  the  patient  to  a  more  wholesome  abode, 
by  changing  the  bed-chamber,  taking  off  the  corset  or 
any  other  hurtful  piece  of  dress,  etc.  The  physician 
ought  likewise  to  insist  upon  his  patient  correcting  all 
bad  habits,  such  as  sitting  crooked,  eating  too  fast, 
swallowing  food  which  is  too  hot,  eating  hot  and  cold 
things  in  rapid  succession,  excessive  use  of  tobacco 
and  snuff,  indiscreet  bathing,  washing  the  head  and 
eyes  with  cold  water  immediately  after  rising,  sitting 
in  a  current  of  air,  etc. 

All  injurious  external  influences  have  to  be  removed 
or  neutralized  before  the  real  treatment  of  the  disease 
can  begin  ;  and  this  treatment  is  to  be  based  upon  the 
principle  "  similia  similibus,"  which  is  the  only  true 
law  of  healing  and  has  now  been  confirmed  by  the 
experience  of  a  vast  number  of  the  most  acute  and 
intelligent  practitioners. 


52  INTRODUCTION. 

The  specific  treatment  as  we  understand  it  in  our 
school,  consists  in  selecting  a  remedial  agent  the  patho- 
genetic  effects  of  which  upon  the  healthy  organism  are 
similar  to  the  symptoms  of  the  natural  disease.  This  is 
the  homoeopathic  law  of  cure,  a  law  which  is  founded 
in  nature  and  is  the  only  true  guide  for  the  administra- 
tion of  such  remedies  as  will  secure  a  successful  reac- 
tion of  the  organism.  If  we  conceive  the  law  "similia 
similibus  "  in  its  true  scientific  extent,  we  will  at  once 
be  led  to  admit  the  necessity  of  not  restricting  the 
application  of  that  law  to  the  mere  external  symp- 
toms ;  for  there  are  diseases  \vhere  those  symptoms 
are  wanting  or  so  feeble  that  we  are  scarcely  able  to 
distinguish  them,  as  may  be  the  case  when  organs  that 
are  but  poorly  provided  with  nerves  and  are  therefore 
not  very  sensitive,  are  the  seat  of  the  disease  ;  or  the 
symptoms  of  the  original  malady  may  be  so  deceptive 
that  the  concomitant  sympathetic  symptoms  may  be 
much  more  distinct  than  the  former  ;  or  the  symptoms 
of  the.  principal  disease  may  be  obscured  by  accidental 
violent  complications.  This  shows  that  a  mere  compar- 
ison of  the  symptoms  is  not  always  sufficient  to  obtain  a 
correct  diagnosis  and  that  it  frequently  requires  a  good 
deal  of  combination  and  reflection  to  attain  a  true  and 
complete  image  of  the  disease  with  all  its  external  and 
probable  internal  phenomena. 

The  selection  of  our  remedial  agents  in  accordance 
with  the  symptoms  of  the  disease,  is  the  great  differ- 
ence which  exists  between  the  old  and  new  school. 
The  greater  the  similarity  of  the  symptoms  ;  the  more 
exactly  the  remedy  corresponds  to  all  the  peculiarities 
of  the  disease ;  to  the  period  when  it  makes  its  appear- 
ance ;  to  the  exacerbations  and  changes  occurring  in  the 
course  of  the  disease ;  to  the  mode  how  and  the  period 
when  it  disappears ;  to  moral  emotions,  etc. :  the  safer, 
and  the  more  certain  and  permanent  is  the  cure.  In 
comparing  the  symptoms  of  the  malady  with  those  of 
the  remedial  agent,  the  general  symptoms  are  of  not  so 
much  importance  as  the  particular  characteristic  symp- 
toms, for  instance,  whether  the  symptoms  are  aggra- 
vated or  excited  by  motion  ;  whether  they  are  excited 


INTRODUCTION.  53 

or  gradually  increased  by  rest,  and  whether  they  dis- 
appear again  by  motion  ;  whether  the  symptoms  are 
most  violent  in  the  morning,  at  noon,  in  the  evening, 
night,  etc.  ;  whether  they  are  modified  by  the  cool 
open  air  or  by  warmth  ;  whether  a  slight,  apparently 
trivial  occurrence,  such  as  nausea,  vomiting,  a  slight 
attack  of  rheumatism,  etc.,  induces  great  prostration  of 
strength,  obliging  one  to  lie  down  (we  remind  the  read- 
er of  Ars.,  Verat.,  Ipec.,  Sec.),  etc.  It  is  of  the  utmost 
importance  for  the  selection  of  the  true  remedial  agent 
that  all  those  points  should  be  carefully  considered. 
We  are  frequently  led  to  a  knowledge  of  the  specific 
agent  by  considering  the  relation  which  it  holds  to  the 
peculiar  moral  or  physical  disposition,  the  temperament 
or  sex  of  the  patient,  (Nux  vom.,  Ignat.,  Puls.,  Sep., 
Phosph.,  etc.) 

The  prophylactic  treatment  is  another  species  of 
treatment  which  the  homoeopathic  physician  is  fre- 
quently called  upon  to  employ. 

The  prophylactic  treatment  is  generally  employed 
in  cases  where  diseases  can  be  prevented  by  specific 
remedies,  for  instance  scarlatina  and  hydrophobia  by  a 
few  small  dozes  of  Belladonna  at  suitable  intervals  ; 
purpura  miliaria  by  Aconite  ;  varicella  and  measles  by 
Pulsatilla ;  the  consequences  of  chagrin  by  Chamomilla 
(or  rather  by  Colocynth,  which  is  in  many  cases  suffi- 
cient to  remove  the  most  violent  symptoms  occasioned 
by  chagrin)  ;  the  morbid  phenomena  resulting  from 
fright  by  Aconite,  etc. 

These  few  examples  sufficiently  show  that  the  ho- 
mceopathic  method  of  cure  is  a  better  prophylactic 
method  than  the  method  of  the  old  school.  We 
inquire  with  much  more  minuteness  into  the  natural 
susceptibility  of  a  patient  to  this  or  that  disease  ;  our 
knowledge  of  the  curative  virtues  of  drugs  is  not 
derived  from  unfounded  theories,  but  it  is  based  upon 
pure  experience  and  careful  observation  ;  such  things 
as  spring  or  milk-cures  can  never  occur  in  homeopathic 
practice. 

The  homoeopathic  physician  acknowledges  also  a 
sort  of  prophylactic  hygiene  which  it  is  the  business  of 


54  INTRODUCTION. 

the  government  to  protect.  Under  this  category 
belongs  Hahnemann's  remark  in  the  preface  to  Ledum 
palustre,*  that  this  powerful  substance  is  frequently 
mixed  with  beer  by  interested  and  unprincipled  brewers 
for  the  purpose  of  imparting  intoxicating  qualities  to  that 
beverage,  thus  making  it  very  injurious  to  health. 

However  strange  it  may  appear  to  speak  of  palli- 
ative treatment  in  connection  with  homoeopathy,  yet 
that  treatment  is  employed  under  certain  circumstances 
even  by  those  who  have  practised  homoeopathy  for 
years  past.  A  physician  must  be  very  unfeeling  if  he 
would  refuse  to  palliate  the  troublesome  or  dangerous 
symptoms  in  cases  where  they  are  owing  to  the 
presence  of  an  exciting  cause,  or  when  the  case  is 
hopeless  and  the  curative  treatment  is  of  no  avail. 
Every  good  physician  will  endeavour  to  palliate  his 
patient's  sufferings  until  his  death,  in  all  cases  \vhere  a 
cure  is  out  of  the  question.  This  rule  of  conduct, 
which  is  deeply  written  in  the  human  heart,  is  not 
only  true  in  incurable  but  also  in  very  painful  diseases. 
This  maxim  prevails  alike  in  the  homoeopathic  as  well 
as  the  allopathic  practice,  with  this  difference,  that 
in  the  latter  practice  palliatives  are  frequently  re- 
sorted to  for  the  purpose  of  subduing  a  single  symptom, 
even  if  the  totality  of  the  symptoms  should  indicate  a 
totally  different  remedy,  (we  merely  mention  the  abuse 
which  is  made  of  opium,  the  sudden  suppression  of 
salutary  evacuations,  the  pellentia  and  exsiccantia  in 
chronic  local  affections,  etc.) 

In  treating  a  case,  the  homoeopathic  physician 
employs  remedies  which  not  only  correspond  to  the 
troublesome  symptom,  but  to  the  whole  group.  In 
palliating  acute  pain  or  incurable  affections,  the  homo3- 
opathic  physician  ought  constantly  to  act  in  accord- 
ance with  that  rule.  He  will  accomplish  that  pallia- 
tion by  frequently  repeating  the  suitable  remedies,  for 
instance :  Belladonna,  Chamom.,  Ignat.,  Ipec.,  etc.,  in 
violent  spasmodic  diseases ;  Carbo  anim.,  Staphys., 
Thuja,  Secale  corn.,  Puls.,  Bell.,  etc.,  in  cancer  of  the 

*  See  Hahnemann's  Materia  Medica  Pura,  by  Charles  J.  Hempel,  M.D. 


INTRODUCTION.  55 

womb.  There  are  many  more  examples,  all  of  which 
show  that  the  principle  "  similia  similibus,"  if  employ- 
ed as  the  rule  in  the  palliative  treatment,  accomplish- 
es the  object  of  that  treatment  much  better  than  the 
empirical  practice  of  the  old  school.  We  invite  our 
opponents  to  try  our  law  of  cure  as  a  palliative  means 
in  organic  malformations,  and  to  compare  the  results 
thus  obtained  with  the  results  obtained  by  their  ordi- 
nary means. 

There  is  another  kind  of  palliative  means  of  which 
we  avail  ourselves  in  our  practice  and  which  have  not, 
it  is  true,  any  homoeopathic  relation  to  the  disease,  but 
by  no  means  interfere  with  the  homoeopathic  treatment. 
Who  does  not  know  that  the  troublesome  dry  cough  in 
tuberculous  phthisis  is  moderated  by  inhaling  the 
vapour  of  warm  water,  or  that  spasms  of  the  respira- 
tory organs  may  be  soothed  by  warm  fomentations  of 
the  chest  ?  Who  is  unacquainted  \vith  the  bene- 
ficent influence  of  animal  magnetism  in  asthmatic  com- 
plaints and  spasms  ?  Who  does  not  use  warm  poul- 
tices of  milk  and  oatmeal,  bran,  or  linseed,  to  soften  hard 
and  painful  abscesses,  or  to  cover  large  ulcerated 
surfaces  which  are  very  painful  and  deprive  the 
patient  of  his  strength  ?  Who  does  not  cover  open 
abscesses  with  bands  of  linen  slightly  covered  with  an 
ointment  of  althea?  Do  we  not  apply  carrot  and 
potato  poultices  to  painful  cancerous  ulcers  and  to  bed- 
sores which  threaten  to  become  gangrenous  ?  Do  we 
not  bathe  inflamed  portions  of  the  periosteum  during  a 
long  confinement  in  bed  with  washes  of  lemon-juice 
and  dilute  tincture  of  Arnica  ?  Who  does  not  give 
anxious  patients,  if  they  should  wish  to  be  relieved  of 
an  obstinate  obstruction  of  the  bowels,  an  injection  of 
tepid  water,  or  milk  and  water,  milk  and  molasses, 
soap-water  and  linseed-oil,  or  mere  cold  water  1  Do 
we  not  know  that  in  typhus  fever  great  relief  may  be 
afforded  to  the  patient  by  washing  certain  parts  of  the 
body  with  warm  vinegar  ?  Have  we  forgotten  the 
relief  which  may  be  obtained  by  rubbing  with  a  piece 
of  flannel  limbs  that  are  affected  with  rheumatism  ;  is 
not  the  pain  in  acute  rheumatism  and  aseites  relieved 


66 

by  friction  with  warm  oil  ?  Are  not  warm  baths  ex- 
cellent palliatives  in  many  cases  ?  Should  it  be 
contrary  to  our  art  to  apply  in  many  cases  of  incipient 
or  perfectly  developed  encephalitis  cold  water,  snow  or 
ice  to  the  head,  knowing  as  we  do  that  those  applica- 
tions have  a  soothing  and  even  curative  effect  in  the 
headache  occurring  in  that  disease  and  arising  from 
violent  congestion  of  blood  ?  Are  not  gargles  of  milk 
and  althea-root  boiled  together,  frequently  useful  in 
angina  faucium  ?  Is  not  the  pain  in  violent  inflamma- 
tion or  suppuration  of  the  internal  ear  relieved  by  the 
vapours  of  warm  milk  1  Is  not  the  painful  otalgia  of 
children  relieved  by  twisting  a  sulphur  thread  around 
the  external  ear?  Are  not  habitually  cold  feet 
relieved  by  bathing  them  in  cold  water  ?  Is  not  the 
agony  in  croup  mitigated  by  applying  a  sponge  dipped 
in  warm  water  to  the  larynx  ?  * 

The  derivative  method  is  a  particular  branch  of  the 
palliative  system,  and  may  be  advantageously  resort- 
ed to  in  many  dangerous  affections.  We  may  men- 
tion the  warm  oatmeal  poultices,  the  hand  and  foot 
baths  with  or  without  salt  or  ashes,  in  congestion  of 
the  superior  organs  and  in  delirium  ;  dry  cupping  at 
the  pit  of  the  stomach,  in  oppression  of  the  chest, 
anguish  and  restlessness  with  an  unequal  and 
spasmodic  pulse  previous  to  an  acute  eruption 
breaking  out  upon  the  skin ;  the  warm  hand-baths  in 
excessive  secretion  of  milk ;  the  application  of  warm 
vapours  to  the  breasts  of  the  lying-in  woman  in  sup- 
pression of  the  milk  ;  the  pitch-plasters  between  the 
shoulders,  which  were  even  recommended  by  Hahne- 
mann  in  chronic  diseases  arising  from  a  suppressed 
eruption ;  the  recommendation  of  Hahnemann  to  wash 
the  external  opposite  side  of  the  affected  organ  with 
the  medicine  which  is  homoeopathic  to  the  symptoms. 
— What  dangerous  symptoms  frequently  arise  from 
suppressed  sweat  of  the  feet  ?  Is  it  not  proper  that 

*  To  these  palliative  means  we  may  add  a  current  from  the  magneto- 
electric  machine,  which  frequently  relieves  in  a  moment's  time  the  most  ex- 
cruciating pain  in  acute  rheumatism,  and  other  kinds  of  inflammation. 

HKMFXL. 


INTRODUCTION.  57 

the  physician  should  endeavour  to  restore  the  sweat 
by  wrapping  the  feet  in  cotton,  wool,  or  wax-linen,  or 
inserting  them  in  warm  sand  ?  There  is  no  doubt  that 
an  illness  depending  upon  a  suddenly  suppressed  cu- 
taneous eruption,  whether  the  suppression  be  spon- 
taneous or  the  result  of  indiscreet  treatment,  will 
be  most  speedily  cured  by  him  who  first  succeeds  in 
restoring  a  similar  eruption  upon  the  skin.  Who  is 
not  acquainted  with  the  brilliant  effects  of  cold  fo- 
mentations and  the  internal  use  of  Arnica  in  injuries  of 
every  kind,  especially  those  of  the  head  ? — Is  not  the 
treatment  which  we  resort  to  in  cases  of  swoons, 
apparent  death,  suffocation,  hanging,  freezing,  burns, 
etc.,  of  the  palliative  kind  ?  * 

We  may  here  mention  another  method  of  treatment 
which  is  subordinate  to  the  homoaopathic,  and  is  based 
upon  a  knowledge  of  drugs  obtained  ex  usu  in  morbis. 
Thus  we  use  Antimonial  \vine,  in  drops,  against  accu- 
mulation of  mucus  in  the  chest,  in  the  case  of  little 
children;  Oleum  jecoris  aselli  against  scrofulous  com-, 
plaints  and  tubercles  ;  Mercurius  in  syphilis  ;  the  bin- 
iodide  of  Mercury  in  old  syphilitic  ulcers,  and  syphi- 
litic diseases  generally ;  Quinine  in  various  intermit- 
tent diseases  ;  Sulphur  in  scabies  and  haemorrhoidal 
affections  ;  Iodine  in  mercurial  herpetic  eruptions  and 
tubercles ;  Lichen  Islandicus  in  pulmonary  phthisis  ; 
Secale  cornutum  to  facilitate  labour-pains  ;  the  tinc- 
ture of  Cinnamon  in  metrorrhagia,  etc. 

We  have  similar  specifics  in  the  homoeopathic  prac- 
tice ;  but  we  have  no  right  to  reject  remedies,  the  spe- 
cific curative  effects  of  which  we  only  know  ex  usu  in 
morbis  ;  the  use  of  such  remedies  is  justified  by  the  fact 
of  their  being  specifically  adapted  to  certain  forms  of 
disease.  Not  every  diarrhoea  from  cold  is  relieved  by 
Dulcamara,  nor  are  all  catarrhal  diseases.  Belladon- 
na is  said  to  be  a  valuable  remedy  against  hydropho- 
bia ;  but  \vould  a  homoeopathic  physician  be  willing 
to  use  it  in  practice  without  first  examining  its  cura- 
tive virtues  ?  Colocynthis  is  known  to  be  an  excellent 

*  OrgAnon  of  the  Specific  Healing  Art,  by  Dr.  G.  L.  Rau.     L«ip«ic,  1838. 

8* 


58  INTRODUCTION. 

remedy  in  colic  with  dysentery,  but  will  a  discreet 
practitioner  ever  use  it  in  such  a  case  without  in- 
quiring whether  it  is  specifically  corresponding  to  it? 
Rhus  is  known  ex  usu  in  morbis  to  be  a  valuable 
remedy  in  many  diseases  which  are  aggravated  in 
rest,  and  Bryonia  in  many  others  which  are  aggravated 
by  motion  ;  nevertheless  we  shall  always  have  to  con- 
sider whether  either  of  those  remedies  is  specifically 
adapted  to  the  existing  group  of  symptoms.  The  same 
remarks  apply  to  Mercury  in  syphilis,  Sulphur  in  sca- 
bies and  haemorrhoids,  China  in  intermittent  fevers, 
Arnica  in  contusions,  Ipecacuanha  and  Ignatia  in 
spasms,  etc. 

We  ought  not  to  omit  mentioning  the  law  of  cure 
"  aequalia  aequalibus,"  or  the  contagium  of  a  disease 
may  be  employed  against  it  as  a  curative  specific. 
This  law,  which  was  first  discovered  and  promulgated 
by  the  veterinary  physician,  M.  Lutz,  in  a  pamphlet 
entitled  the  Doctrine  of  Isopathic  Remedies,  and  pub- 
lished in  Leipsic,  1833,  has  been  confirmed  by  the  ex- 
perience of  many  acute  observers.  In  making  men- 
tion of  this  work  in  the  second  volume  of  the  Homoeo- 
pathic Gazette,  No.  9,  page  70,  Dr.  Gross  tells  us  that 
he  had  made  many  experiments  with  isopathic  reme- 
dies. Since  then  several  cures  by  means  of  isopathic 
remedies  have  been  reported  in  the  Homoeopathic  Ga- 
zette ;  but  they  do  not  always  prove  what  they  are  in- 
tended to  prove,  and  have  appeared  to  us  rather  im- 
aginary. There  is  no  doubt  that  single  observations 
have  been  made  the  basis  of  the  doctrine  that  the  pro- 
duct of  a  disease  is  abld  to  cure  that  disease,  and  that 
this  erroneous  conclusion  has  brought  into  use  a  num- 
ber of  remedies  which  do  not  deserve  that  name.  We 
know  that  contagia  are  not  only  capable  of  subverting 
the  normal  condition  of  the  vital  forces,  but  also  of  re- 
storing the  natural  play  of  those  forces  (we  need  but 
mention  Pspricum,  Lachesis,  Vaccinin,  Morbillin,  Va- 
riolin)  ;  but  those  remedies  have  most  frequently  cured 
diseases  entirely  different  from  those  from  whose,  names 
those  agents  have  derived  their  own.  If  all  diseases 
could  be  cured  in  this  manner  the  business  of  a  physi- 


INTRODUCTION.  59 

cian  would  not  be  difficult  but  very  laborious,  inas- 
much as  he  would  have  to  dynamize  the  product  of 
the  disease  in  every  single  case  ;  for  any  other  it 
would  be  without  any  value.  Cures  which  are  said 
to  have  been  effected  agreeably  to  the  principle,  "  ae- 
qualia  aequalibus,"  are  in  fact  homoeopathic  cures ; 
for  the  patient  is  cured  by  means  of  a  product  of  that 
disease  in  some  other  patient,  which  is  dynamized  in 
the  usual  fashion. 

Inasmuch  as  we  have  made  mention  of  the  various 
methods  of  treatment  of  which  the  homoBopathic  prac- 
titioner may  avail  himself,  we  shall  now  say  a  few 
words  of  some  other  methods  occurring  in  allopathic 
practice,  and  comprehended  in  one  or  the  other  above- 
mentioned  methods  of  cure. 

HonioBopathy  knows  nothing  of  the  expectant 
method.  '  Every  manifestation  of  disease  is  treated 
according  to  its  symptoms,  by  positive  remedies. 

Nor  does  homoeopathy  know  anything  of  a  particu- 
lar treatment  for  convalescent  patients.  The  efforts 
of  the  homoeopathic  physician  are  directed  against  the 
disease  itself,  without  poisoning  the  organism,  as  is 
done  in  old-school  treatment,  by  excessive  doses  of 
medicine,  frequently  ingrafting  upon  the  organism  an 
artificial  disease  that  is  much  more  violent,  and  lasts 
much  longer  than  the  natural  disease.  Homceopathy 
does  not  use  any  depletory  processes  ;  hence  the  pa- 
tient is  not  weakened  by  homoeopathic  treatment,  and 
there  is  no  necessity  for  any  of  those  medicines  which 
are  required  for  the  debility  consequent  upon  the  em- 
ployment of  the  allopathic  revulsive  treatment.  Suf- 
fice it  to  mention  the  cure  of  inflammation  by  repeat- 
ed bleedings,  or  the  treatment  of  typhoid  fevers  with 
excitants  and  a  variety  of  other  drugs  in  large  doses, 
the  use  of  which  is  generally  followed  by  a  period  of 
convalescence  lasting  as  long  as  the  original  disease  ; 
the  treatment  of  febris  pituitosa,  which  generally 
leaves  a  deranged  state  of  the  mucous  membranes  and 
dropsical  conditions,  etc. 

After  these  preliminary  pathological  and  therapeutic 


00  INTRODUCTION. 


observations  we  come  to  state  the  fourth  cardinal 
principle  of  homoeopathic  practice :  Give  the  specific 
remedy  in  a  sufficient  quantity  to  excite  the  curative  re- 
action of  the  organism,  without  occasioning  any  un- 
necessary aggravation  of  the  symptoms,  which  would 
only  serve  to  impede  the  cure.  According  to  Hahne- 
mann  the  homoeopathic  dose  may  be  ever  so  minute  it 
•will  succeed  in  improving,  curing,  or  even  annihil- 
ating the  disease.  His  idea  was  that  the  exciting 
causes  of  disease  possess  only  a  subordinate  and  limit- 
ed power  to  disturb  the  organism,  but  the  remedial 
agents  possess  this  power  in  an  absolute,  and,  there- 
fore, supreme  degree,  at  the  same  time  as  they  are  ca- 
pable of  affecting  the  diseased  organ  in  such  a  manner 
as  will  restore  the  harmony  of  the  whole  organism.  A 
few  hours  after  exhibiting  his  remedy  Hahnemann 
frequently  noticed  new  symptoms  evoked  by  the 
medicine  (medicinal  aggravation)  ;  he  therefore  con- 
cluded that  the  dose  was  still  too  powerful  for  the 
disturbed  organism,  and  was  led  in  the  course  of 
time  to  carry  all  his  remedies  up  to  the  30th  degree 
of  dynamization.  He  was  rejoiced  at  witnessing  the 
effect,  the  pure  dynamis  of  his  immaterial  doses,  and 
the  power  which  even  the  highest  potencies  still  pos- 
sessed to  cure  disease.  He  even  thought  that  those 
highest  dynamizations  were  frequently  too  powerful, 
especially  in  chronic  diseases,  and  he  therefore  intro- 
duced the  method  of  simply  smelling  a  few  pellets 
moistened  with  the  medicine.  Afterwards  he  thought 
that  even  olfaction  was  too  powerful  for  certain  deli- 
cate organisms,  and  he  advised  such  patients  to  dis- 
solve a  few  pellets  of  the  medicine  in  half  a  tumbler- 
ful of  water,  and  of  taking  a  tablespoonful  every  day, 
or  every  two  or  three  days.  According  to  Boenning- 
hausen's  communication  in  the  New  Archive,  first 
and  second  number,  Hahnemann  has  carried  his  dyna- 
mizations still  higher,  and  since  his  death  the  highest 
dynamizations  have  been  vaunted  in  such  extravagant 
terms  that  the  student  of  homoeopathy  must  fairly  lose 
his  senses  in  that  labyrinth  of  strange  and  unheard-of 


DTTRODUCTIOIf.  01 

relations.  There  are  as  yet  no  fixed  rules  for  the 
magnitude  of  a  dose  or  the  employment  of  particular 
potencies  ;  every  physician  uses  those  potencies  which 
seem  to  him  best,  and  if  he  succeeds  in  curing  his  pa- 
tient, he  considers  that  potency  the  best  which  has  ef- 
fected the  cure,  and  advocates  it  as  such,  upon  the  ground 
of  experience.  Nothing  positive  can  be  said  about 
a  point  of  doctrine  which  has  given  rise  to  so  many 
different  opinions.  It  will  not  do  either  to  contradict 
or  to  blindly  believe  the  results  said  to  have  been  ob- 
tained by  other  physicians.  We  ought  to  verify  them 
in  our  own  practice,  although  neither  a  few  successes 
nor  failures  are  a  sufficient  evidence  either  for  or 
against  the  statements  and  inferences  of  other  prac- 
titioners. If  it  were  true  that  in  treating  a  case  of 
disease  the  principal  thing  is  to  give  the  homoBopathic 
specific,  and  that  the  dose  is  of  minor  importance,  we 
might  dismiss  the  subject  without  any  further  remark. 
The  dose,  however,  is  of  some  importance,  and  we 
therefore  beg  leave  to  express  our  own  opinion  in  re- 
spect to  doses,  without  desiring,  however,  to  bias  any 
practitioner's  mind  in  favour  of  our  ideas. 

In  the  first  place  we  ought  to  have  a  proper  under- 
standing of  the  term  dynamization.  Hahnemann  gave 
this  name  to  every  attenuation  of  a  drug,  which  he 
considered  a  development  and  increase  of  the  power 
of  the  drug,  until  the  material  substratum  should  be 
entirely  destroyed  and  the  attenuated  agent  should  act 
as  a  purely  dynamic  power.  The  term  "  dynamization 
or  potentialization  "  is  certainly  the  best  that  can  be 
applied  to  the  attenuations  of  mineral  and  metallic 
substances,  inasmuch  as  the  process  of  trituration  dis- 
closes and  developes  their  latent  powers  and  raises 
the  drugs  to  the  rank  of  true  curative  agents.  It  is 
only  by  triturating  those  crude  substances  that  they 
become  like  medicinal  agents  which,  even  in  their 
natural  state  and  divided  into  very  minute  parts, 
possess  so  great  a  power  of  disturbing  the  organism 
that  it  is  not  advisable  to  use  them  except  highly 
diluted.  *The  former  substances  are  dynamized  by 


62  INTRODUCTION. 

trituration,  the  latter  weakened  by  dilution.  We  do 
not  know  very  positively  how  far  crude  drugs  require 
to  be  dynamized  before  their  medicinal  virtues  are 
properly  disclosed  ;  but  we  may  suppose  that  this  re- 
sult is  obtained  as  soon  as  the  triturated  substance 
manifests  the  power  of  morbidly  affecting  the  organ- 
ism. Any  farther  attenuation  of  the  drug  would  not 
be  a  dynamization  but  a  dilution.  If  the  successive 
attenuations  of  a  drug  were  so  many  dynamizations, 
why  does  not  the  dynamic  power  of  the  drug  increase 
by  attenuation,  whereas  Hahnemann  thinks  that  it 
decreases.  However,  our  intention  is  not  to  criticize, 
but  simply  to  state  the  view  which  we  take  of 
dynamization  and  dilution.  We  understand  the  thing 
differently  from  Hahnemann,  but,  if  we  mean  to  ob- 
tain a  rational  opinion  of  the  power  of  his  small  doses 
we  have  to  understand  the  attenuating  process  as  he 
does.  He  supposed  that  the  dynamic  power  of  pon- 
derable bodies  might  be  excited  by  peculiar  manipu- 
lations like  that  of  imponderable  substances,  and  that 
the  dynamic  power  of  those  substances  might  be 
separated  from  its  material  substratum  and  transferred 
to  a  neutral  vehicle  by  means  of  which  it  might  be 
made  to  act  upon  the  affected  organism  like  electricity, 
magnetism,  etc.  The  correctness  of  the  views  which 
Hahnemann  has  promulgated  about  the  dynamizing 
power  of  the  processes  of  trituration  and  succussion, 
cannot  be  denied,  nor  will  it  be  denied  by  any  one 
who  is  familiar  with  homeopathic  practice,  and  has 
used  the  30th,  40th,  and  60th  potency  of  Arsenic, 
Belladonna,  etc.,  with  the  same  happy  results  as  we 
have  done  in  our  practice.  Latterly,  however,  the 
process  of  dynamization  has  been  carried  much  farther 
than  it  ever  had  been  before,  and  with  so  much  en- 
thusiasm that  it  is  impossible  to  foresee  its  ultimate 
boundaries.  The  advocates  of  the  doctrine  of  dynam- 
ization have  now  become  convinced  that  the  whole 
secret  of  the  curative  effects  of  one,  two  or  three 
pellets  is  explained  by  the  peculiar  mode  in  which  the 
medicine  has  been  triturated  and  succussecl.  They 


INTRODUCTION.  63 

carry  a  remedy  up  to  the  800th,  1000th,  and  even 
2000th  potency,*  and  imagine  that  those  high  poten- 
cies still  produce  pathogenetic  symptoms.  If  this 
game,  which  is  particularly  exciting  to  laymen,  and  in 
which  physicians  become  so  easily  interested,  is  car- 
ried much  farther,  the  end  of  it  cannot  possibly  be 
foreseen,  and  it  may  become  true  what  some  of  our 
opponents  have  said  of  us,  that  in  homo3opathic  prac- 
tice nature  triumphs  both  over  the  disease  and  the 
physician  !  We  will  not  decide  whether  the  introduc- 
tion of  the  highest  potencies  has  or  has  not  been  a 
scientific  progress ;  but  we  confess  that  those  poten- 
cies, which  we  have  used  in  many  cases  with  the 
honest  intention  of  testing  their  real  value,  have  not 
answered  our  expectations  as  well  as  they  have  those  of 
Stapf,  Gross,  Bcenninghausen,  and  other  enthusiastic  ad- 
mirers. We  still  recollect  the  time  when  Hahnemann 
supposed  that  all  chronic  diseases  originated  in  the 
use  of  coffee,  until  the  psora  theory  furnished  him  a 
new  clue  for  those  diseases.  Many  homoeopathic 
physicians  have  implicit  confidence  in  the  psora-doc- 
trine. They  likewise  believed  in  the  limit  which 
Hahnemann  had  marked  out  in  the  preface  to  every 
remedy  contained  in  the  first  edition  of  the  Materia 
Medica  Pura  as  the  highest  degree  of  power  of  which 
that  remedy  was  susceptible.  And  who  will  deny 
that  beautiful  cures  were  wrought  by  these  pretended 
highest  potencies  which  were  supposed  to  be  the  most 
suitable  to  the  susceptibility  of  the  disturbed  organ- 
ism. But  even  at  that  time  we  frequently  succeeded 
in  curing  with  a  lower  potency  where  the  higher  had 
no  effect.  No  one  thought  in  those  cases  of  ascending 
the  scale,  and  an  attempt  made  by  Korsakoff  to  carry 
our  remedies  up  to  the  1500th  potency  was  rejected 
as  absurd  by  those  who  were  satisfied  with  the  results 
of  their  present  experience  ;  it  was  supposed  that 
those  potencies  had  no  curative  power  whatsoever, 

*  Baron  Gerstorff,  one  of  the  provers  so  frequently  mentioned  in  the 
Materia  Medica  Pura,  has  told  me  that  Arsenic  has  been  carried  up  to  th« 
10,000th  potency.— HEMPKL. 


64  INTRODUCTION. 

and  that  the  patient  who  was  treated  with  them  re- 
ceived no  medicine  at  all.  It  is  but  a  few  years 
since  the  lowest  potencies  were  recommended  as  the 
most  suitable  in  the  treatment  of  disease,  and  em- 
ployed by  a  great  number  of  physicians.  What 
causes  all  those  changes  ?  Have  the  drugs  become 
more  powerful  ?  Have  the  highest  potencies  been 
made  or  used  improperly  ?  Have  we  obtained  a 
deeper  insight  into  the  spirit  of  our  doctrine  ?  Are 
we  desirous  of  showing  to  the  \vorld  that  homoBopathy 
is  yet  susceptible  of  many  improvements  ?  Certainly 
homoeopathy  is  susceptible  of  improvement,  but  it 
strikes  us  that  it  ought  to  be  effected  by  a  different 
road  than  that  of  the  highest  potencies.  The  proba- 
bility is,  that  if  Hahnemann  had  lived  and  had  re- 
mained in  possession  of  his  vigorous  intellect,  he  \vould 
have  made  changes  in  the  preparation  and  adminis- 
tration of  our  medicines,  and  would  always  have  re- 
commended the  last  change  as  the  best.  This  is  our 
opinion  of  the  highest  potencies  ;  they  may  afford 
advantages  in  certain  cases,  but  will  probably  be 
superseded  one  day  by  a  new  method  of  exhibiting 
our  remedial  agents,  \vhich  will  be  advocated  with 
the  same  enthusiasm  by  its  friends. 

As  it  is  impossible  that  the  same  dose  or  potency 
should  be  suitable  to  all  patients,  the  question  natu- 
rally occurs :  What  dose  will  excite  the  curative  re- 
action of  the  organism  in  a  sufficient  degree  ?  Every 
physician  must  feel  interested  in  the  settlement  of  this 
question,  as  the  dose  is  of  the  utmost  importance  to  a 
successful  treatment.  The  lowest  potencies,  the  thir- 
tieth, and  now  the  highest  potencies,  have  been  suc- 
cessively recommended  as  the  normal  doses.  But  we 
are  convinced,  from  the  many  trials  which  we  have 
made  with  every  one  of  those  preparations,  that 
neither  of  them  can  be  considered  normal,  and  that 
the  dose  depends  in  every  case  upon  the  susceptibilities 
and  the  reactive  power  of  the  patient's  organism.  In 
Rau's  Organon  the  conditions  by  which  the  dose  ought 
to  be  determined  have  been  accurately  described,  and 
we  shall  adopt  them  in  the  present  work,  so  much 


INTRODUCTION.  85 

more  as  the  views  of  Rau  on  that  subject  coincide 
entirely  with  our  own.* 

*  NOTE  BY  DR.  HEMPEL. — Dr.  HartmanrTs  remarks  on  the  highest  potencies 
appear  to  me  rather  superficial.  If  a  man  u»es  the  60th  potency  with  as 
much  success  as  he  pretends  to  do,  there  is  no  good  ground  for  his  being  as- 
tonished at  the  curative  effects  of  the  200th  or  even  the  2000th.  Dr.  Hartman 
denies  that  succussion  is  a  means  of  developing  the  dynamic  power  of  a  drug; 
he  thinks  that  attenuation  by  succussion  is  a  simple  process  of  dilution.  In  this 
I  think  he  is  grievously  mistaken.  How  will  Hartmann  explain  the  fact  that 
a  drop  of  the  tincture  of  Belladonna,  when  simply  stirred  in  a  glass  of  water,  has 
frequently  no  effect,  where  a  few  pellets  of  the  thirtieth  potency  will  effect 
a  speedy  cure,  or  where  a  cure  is  effected  by  that  same  drop  if  it  be  mixed 
in  a  tumblerful  of  water  by  turning  the  solution  some  thirty  or  forty  times 
from  one  tumbler  into  another,  and  then  mixing  a  table  spoonful  of  that  solu- 
tion with  another  tumblerful  of  water  and  turning  this  second  solution  again 
thirty  or  forty  times  from  one  tumbler  into  a  second  one  1  I  can  affirm  that 
I  have  effected  many  cures  with  a  double-attenuated  solution  where  a  simple 
dilution  of  the  tincture  left  me  entirely  in  the  lurch.  As  regards  the 
highest  potencies,  I  protest  both  against  their  exclusive  use  and  against  the 
injudicious  neglect  with  which  many  practitioners  treat  them.  1  have  used 
them  in  many  violent  cases  with  the  most  perfect  and  sometimes  with  in-  " 
stantaneous  effect,  and  do  use  them  now  every  day  to  my  entire  satisfaction. 
I  have  reported  a  number  of  cases  in  the  Homoeopathic  Examiner  where  the 
curative  action  of  the  highest  potencies  is  so  evident  that  no  sane  man  can 
doubt  it,  and  in  many  cases  I  have  obtained  results  by  means  of  the  highest 
potencies  where  the  lower  potencies  had  entirely  failed,  even  when  adminis- 
tered by  skilful  hands.  A  few  weeks  ago  I  was  requested  to  take  charge  of 
a  lady  who  had  been  suffering  with  consumption  brought  on  by  mismanaged 
pneumonia.  Her  most  distressing  symptom  was  a  hard  wheezing  cough  with 
most  difficult  expectoration  ;  she  had  a  turn  every  five  minutes.  This  lady- 
had  been  treated  homoeopathically  for  several  months  past,  and  the  last  medi- 
cine that  had  been  given  her  was  crude  sulphur,  of  which  she  took  three 
powders  a-day,  and  had  already  swallowed  twenty  powders  in  all.  The 
patient  told  me  that  her  cough  had  been  getting  worse  ever  since  she  had 
taken  those  powders,  and  that  her  distress  had  become  so  excessive  that  she 
.could  not  take  the  medicine  any  longer.  Sulphur,  however,  was  the  remedy. 
I  gave  her  two  pellets  of  the  800th  potency  in  water,  a  table  spoonful  every 
six  hours,  and  when  I  saw  her  again,  three  days  after,  her  cough  was  much 
less,  the  paroxysms  were  much  less  frequent  and  less  violent.  TJie  lady  re- 
marked to  me,  "  What  a  comfort  it  is  to  be  able  to  sit  without  coughing." 

In  the  second  number  of  the  Homoeopathic  Examiner,  Vol.  IV.,  I  have  re- 
ported a  case  of  neuralgic  colic  of  upwards  of  three  years'  standing,  which 
had  been  treated  for  eighteen  months  by  the  first  homoeopathic  physicians  of 
this  city.  When  I  took  charge  of  the  patient,  she  suffered  the  most  agon- 
izing pain  from  morning  till  night,  and  the  friends  of  the  patient — a  most  in- 
teresting young  lady — had  given  up  all  hope  of  ever  seeing  her  relieved.  I 
can  affirm,  as  a  man  of  honour,  that  that  patient  has  not  only  been  relieved 
but  entirely  cured,  by  the  200th  potency  of  Ipecacuanha.  I  might  adduce  the 
written  testimony  oi  the  patient's  mother  to  show  that  the  cure  has  been 
complete  ;  but  I  forbear  on  account  of  the  flattering  remarks  contained  in 
that  paper. 

Among  other  cases  where  the  lower  preparations  have  failed  entirely  and 
where  the  highest  potencies  have  effected  a  cure,  I  may  mention  the  follow- 
ing : — A  gentleman  of  thirty  years  had  an  inflammatory  rheumatic  fever 
which  was  treated  allopathically  ;  in  the  course  of  the  treatment  he  lost  his 
appetite,  his  bowels  became  affected,  and  after  the  treatment  had  lasted  a 
whole  year  he  concluded  to  submit  to  homoeopathic  treatment.  His  symp- 
toms were  :  Constant  uneasiness  about  the  bowels,  excessive  qualmishness, 
constant  desire  to  evacuate  the  bowels,  which  were  very  sluggish  ;  violent 


66  INTRODUCTION. 

The  susceptibility  to  medicinal  influences  is  greatest 
in  very  small  children  and  is  at  its  acme  in  subjects 
entering  upon  pubescence,  a  period  when  the  more 
noble  developments  take  place.  These  are  epochs 
when  (as  a  general  rule — Trans.)  the  organism  requires 
but  minute  doses  of  medicine  which  ought  to  be  so 
much  more  minute  as  the  medicine  has  a  specific  rela- 
tion to  the  organ.  This  observation  is  likewise  appli- 
cable to  females,  who  generally  require  smaller  doses. 

The  constitution  of  the  patient  is  likewise  to  be 
taken  into  consideration.  Phlegmatic  and  torpid 
temperaments  require  the  lower  attenuations  ;  sensitive 
persons,  on  the  contrary,  with  a  sanguine  or  choleric 
temperament,  the  higher.  Persons  whose  sensibility 
has  become  obtuse  in  consequence  of  the  abuse  of 
spirituous  and  heating  beverages,  spices,  piquant 
dishes,  require  larger  doses  of  medicine  to  excite  the 
necessary  organic  reaction.  This  shows  that  the  mode 
of  life  has  a  great  influence  on  the  constitution. 
Mental  labour,  the  reading  of  novels  which  excite  the 
imagination,  a  sedentary  and  effeminate  mode  of  life, 
and  long  sleeping,  increase  the  sensibility ;  heavy  labour, 
country-air,  substantial  and  nutritious  food,  living  in 
apothecaries,  or  tobacco-shops,  distilleries,  etc.,  diminish 
it.  It  is  likewise  certain  that  persons  who  have  been 
treated  with  Lead,  Mercury,  Iodine,  Cinchona,  Valeri- 
ana,  and  other  drugs,  and  are  now  suffering  with  a  corn- 
shooting  pain  from  temple  to  temple  through  the  forehead,  occasionally  a 
neuralgic  pain  in  a  small  circumscribed  spot  of  the  left  parietal  bone  ;  but 
his  greatest  trouble  was  an  abominable  coating  of  the  tongue,  which  was  at 
least  one  line  in  thickness,  and  had  a  most  horrid  appearance  ;  when  I  saw  it 
for  the  first  time  it  positively  sickened  my  stomach.  That  gentleman  enjoyed 
for  six  months  in  succession  the  treatment  of  a  distinguished  homoeopathic 
physician,  under  which  he  got  worse  instead  of  better.  I  cured  him  with  the 
206th  and  300th  potency  of  Aconite,  bowels,  head,  tongue  and  all ;  his  tongue 
now  looks  as  clean  as  any  man's. 

Why  should  we  close  our  eyes  to  such  facts  1  No  honest  practitioner  does, 
but  alas!  how  few  are  there  among  us  who  are  honest  and  devoted  inquirers. 
Most  physicians  look  upon  themselves  as  accomplished  artists,  who  cannot 
learn  anything  of  anybody,  and  who  ought  to  reject  and  deride  the  experi- 
ence of  their  fellow-practitioners  if  it  should  at  all  appear  strange  and  some 
exertions  should  be  required  in  investigating  and  verifying  it.  How  an  ex- 
perimental science  is  to  be  benefitted  by  such  want  of  application  and  by  so 
much  impudent  conceit,  is  difficult  to  understand.  Fortunately  the  interests 
of  true  medicine  are  not  jeopardized  by  the  neglect  of  a  few  men,  and,  be- 
sides, there  are  plenty  of  brave  men  in  the  homoeopathic  ranks  who  will 
never  shrink  from  fulfilling  their  high  trust. 


INTRODUCTION.  67 

plication  of  the  natural  disease  and  medicinal  poisoning, 
require  larger  doses  than  would  have  been  necessary  , 
previous  to  such  a  poisoning  having  taken  place.* 
Climate  has  also  a  powerful  influence  on  the  constitu- 
tion, and  indirectly  upon  the  magnitude  of  the  dose,  as 
we  know  from  experience. 

The  character  of  the  disease,  which  we  are  called 
upon  to  treat,  is  likewise  an  important  consideration  in 
the  selection  of  the  dose.     Erethism  and  torpor  cannot  * 
possibly  be  treated  with  the  same  dose.     In  a  state  of  I 
erethism  the  vital  functions  are  carried  on  with  great'' 
rapidity,  and  require  for  their  regulation  the  higher! 
potencies  ;  in  torpor,  on  the  contrary,  the  vitality  is 
very  much  depressed,  and  requires  to  be  roused  into  re- 
action by  larger  and  stronger  doses.     Inflammatory  and 
spasmodic  affections  soon  show  a  favourable  reaction 
after  the  use  of  high  potencies,  etc. 

The  magnitude  of  the  dose  is  also  determined  by  the 
seat  of  the  disease,  for  the  greater  the  sensitiveness  of 
the  affected  organ,  the  smaller  ought  to  be  the  dose,  and 
vice  versa.  In  general  we  may  lay  it  down  as  a  rule, 
that  affections  of  the  vegetative  system,  unless  they 
are  of  a  decidedly  inflammatory  nature,  require  larger 
doses,  as  do  likewise  affections  of  the  mucous  mem- 
branes. 

The  intensity  with  which  the  drug  of  its  own  nature  is 
prone  to  act,  seems  to  require  a  particular  consideration 
in  determining  the  dose.  It  is  true  that  in  his  later 
years  Hahnemann  and  the  admirers  of  the  highest  po- 
tencies have  overlooked  that  rule.  What  a  difference 
there  is  in  respect  to  the  intensity  of  action  between 
Sambucus,  Viola-odorata,  Verbascum,  Leontodon, 
Euphrasia,  Dulcamara,  Crocus,  etc.,  and  Belladonna, 
Arsenic,  Rhusj  Phosphorus,  Corr.  subl.,  Lachesis,  Pso- 
ricum,  and  many  more. 

Does  not  the  affinity  of  certain  remedies  to  cer- 
tain organs  require  a  particular  consideration  ?  Un- 
doubtedly it  does.  The  more  homoeopathic  the 

*  The  best  means  to  relieve  the  organism  of  the  influence  of  such  medici- 
nal poi-fins  is  the  hydropathic  treatment,  which  ought  to  precede  the  homoe- 
opathic treatment. — HEOTEL. 


C8  INTRODUCTION. 

remedy  is  to  the  disease,  the  smaller  ought  to  be 
the  dose.  Sulphur  is  a  specific  to  many  diseases 
where  its  best  effects  are  exhibited  by  the  high  attenua- 
tions, whereas  in  scabies  repeated  doses  of  a  lower  po- 
tency do  more  good  than  the  higher  attenuations. 
In  many  catarrhal  diseases  to  which  Dulcamara  is  a 
specific,  the  lower  potencies  of  that  drug  will  do  more 
good  than  the  higher.  Rheumatic  paralysis  for  which 
Bellad.  is  indicated,  requires  a  much  stronger  dose  than 
encephalitis.  In  inflammatory  fevers  large  doses  of 
Aconite  may  be  given  when  it  is  not  homoeopathic  to 
the  local  inflammation ;  whereas,  if  this  homoeopath- 
icity  exist,  the  higher  potencies  of  Aconite  are  re- 
quired. 

In  some  cases  the  higher  potencies  of  the  specific 
remedy  are  without  any  effect ;  this  makes  it  necessary 
that  we  should  employ  the  lower  attenuations  except 
when  there  is  a  peculiar  idiosyncrasy  toward  one  or 
the  other  remedy,  as  is  known  to  be  the  case  with  Nux, 
Arnica,  Crocus.  China,  Mercurius,*  of  which  the  high- 
er attenuations  are  required  in  all  such  cases. 

If  in  prescribing  a  remedy,  we  consider  carefully  the 
various  conditions  which  have  been  indicated  in  the 
foregoing  paragraphs,  we  shall  in  most  cases  be  enabled 
to  give  a  dose  which  will  be  just  sufficient  to  excite  the 
necessary  curative  reaction  in  the  affected  organ. 
From  all  this  we  see  that  the  dose  ought  to  be  strong 
or  weak  according  to  the  nature  of  the  case,  and  that 
even  a  weak  dose  may  yet  produce  an  exacerbation 
of  the  symptoms.  This  exacerbation,  however,  is  not 
a  necessary  occurrence,  since  it  frequently  happens  that 
the  patients,  instead  of  experiencing  an  exacerbation 
of  the  symptoms,  feel  a  peculiar  quietude,  a  disposition 
to  sleep ;  sometimes  even  they  fall  into  a  sound  sleep 
which  lasts  a  longer  or  shorter  space  of  time  and  is 

*  I  have  had  a  female  patient  who  could  not  take  Aconite  or  Digitalis, 
which  she  required  to  take  for  a  nervous  disorder,  without  experiencing  a 
most  distressing  nausea,  which  would  sometimes  he  felt  even  after  taking  the 
200th  potency.  Whenever  her  nervous  system  had  become  excited  by 
fright  or  by  other  causes  which  seemed  to  require  the  administration  of 
Aconite,  she  expressed  an  utter  aversion  to  Aconite.  Coffea  soothed  her  iu 
a  moment. — HEMFEL. 


INTRODUCTION.  69 

generally  very  refreshing,  and  from  which  the  patients 
sometimes  wake  cured,  if  the  nature  of  the  case  admit 
of  such  a  speedy  change.  Both  the  medicinal  aggrava- 
tion and  the  soothing  effect  of  the  remedy  are  sure 
proofs  to  the  homoeopathic  physician  that  the  remedy 
is  well  chosen.  Although  that  remarkable  phenome- 
non occurs  both  in  acute  and  chronic  diseases,  yet  it 
is  seen  much  more  frequently  in  affections  charac- 
terized by  a  morbid  excitement  of  the  organic  life, 
especially  when  the  higher  organs  are  involved,  in  ner- 
vous irritation,  spasms  of  every  kind,  erethism  of  the 
vascular  system,  including  pure  inflammation,  erethism 
of  the  lower  organs,  such  as  the  mucous  membranes, 
glands,  bones,  etc.  (but  much  less  frequent  in  the  lat- 
ter), in  irregularity  of  the  sleep.  Children,  in  whom 
the  vegetative  system  prevails,  are  especially  apt  to 
sleep  after  taking  the  true  homoeopathic  specific.* 

Since  it  is  an  established  fact  that  a  true  homoe- 
opathic specific  may  either  produce  an  exacerbation 
of  the  symptoms,  or  a  curative  sleep,f  and  we  are  un- 
able to  determine  the  normal  dose  which  will  under 
all  circumstances  occasion  those  results,  we  therefore 
advise  the  beginning  practitioner  not  to  pledge  him- 
self to  any  dose  in  particular  but  to  use  the  whole 
scale  of  potencies  to  the  best  of  his  judgment. 

What  has  been  most  perplexing  to  the  scepticism  of 
the  old  school  is  the  possibility  that  such  small  doses 
should  have  any  effect  upon  the  organism.  This  scep- 
ticism arises  principally  from  the  fact  that  old  school 
physicians  give  their  remedies  every  hour  in  a  crude 
state  anil  in  large  quantities,  and  have  no  idea  of  the 
dynamfl|)ower  residing  in  a  drug.  However  much 
the  human  understanding  may  be  at  a  loss  to  account 
for  the  power  of  our  small  doses  by  any  thing  known 
in  scienoeAhere  is  no  doubt  that  the  possibility  of  such 
action  mlwSrtao.t  only  be  conceived  according  to  natu- 

' 


*  See  refl.ec*i<lj^_on-Sleep,  which  is  in  many  cases  a  direct  result  of  the 
action  of  horiiceopathic'specifics  upon  the  affected  organism  ;  by  Dr.  E.  Stapf, 
ArchivelttJRH.  VT,  No.  3,  p".  1. 

t  Seepfo.  4  of  Vol.  IV.  of  Horn.  Exam.,  in  the  case  of  typhoid  meningitis  re- 
ported by  Dr.£M«mpel,  where  this  curative  sleep  set  in  almost  immediately 
after  the  administration  of  Hyosciamus  30. 


70  INTRODUCTION. 

ral  laws,  but  that  it  has  been  proven  by  the 
universal  experience  of  all  homeopathic  physicians. 
To  cure  diseases,  both  homoeopaths  and  allopaths  use 
medicines.  All  those  substances  Avhich  we  use  as 
drugs,  must  be  able  to  disturb  the  organism  by  their 
direct  action  upon  it,  each  in  a  specific  manner.  From 
a  central  point  the  morbid  phenomena  spread,  invading 
successively  other  systems.  If  we  consider  the  action 
of  remedies  from  that  position,  we  perceive  at  once  that 
the  homoeopathic  agent  is  alone  suitable  in  all  dis- 
eases. ^It  would  seem  as  if  we  ought  to  stumble  upon 
the  truth  that  a  medicine  and  a  morbid  action  both  of 
which  are  characterized  by  the  same  phenomena, 
t  must  primarily  act  upon  the  same  centre.  On  giving 
a  homcEopathic  remedy  in  a  sufficient  quantity  to 
produce  symptoms,  the  disease  must  necessarily  be 
aggravated  ;  on  the  contrary,  by  giving  the  remedy  in 
so  small  a  dose  that  it  cannot  affect  the  organism 
medicinally,  the  remedy  must  necessarily  act  upon 
the  vitality  of  the  invaded  centre,  from  which  its  in- 
fluence will  successively  extend  over  the  organs  which 
are  consensually  related  to  the  centre  ;  the  disease 
will  therefore  be  cured  without  being  first  aggravated.* 
This  is  no  proposition  of  the  pure  reason,  but  one  de- 
rived from  experience  after  numerous  observations 
and  experiments.  Why  should  we  disbelieve  a  fact 
on  the  ground  of  its  having  been  wrongly  accounted 
for,  and  why  should  we  not  do  again  what  we  have 
done  so  many  thousand  times,  in  order  to  obtain  again 
the  same  good  results  ?  We  do  not  deem  it  necessary 
to  repeat  in  the  present  instance  the  many  striking 
proofs  which  have  been  offered  to  the  opporo?nts  of 
homoeopathy,  that  striking  effects  are  frequently  pro- 
duced by  spiritual,  or  dynamic  forces.  We  will  simply 
state  that  if  the  healthy  organism  can  be  influenced 
by  atmospheric  impressions,  atmospheric  vibrations 
upon  \vhich  the  perception  of  sound  and  light  depends, 
and  by  other  imponderable  agents,  why  should  it  be 

denied    that  an  organism  invaded  by  disease  can  be 

• 

*  See  Ideas  on  the  Formation  and   Cure  of  Disease  by  D.  Drechsler  of 
Diiben,  in  the  Med.  Annals  of  Altenburg,  March,  1815. 


INTRODUCTION.  71 

acted  upon  by  minute  doses  of  highly  refined  thera- 
peutic agents  when  it  cannot  be  denied  that  those  agents 
possess  a  dynamic  power.  We  refer  the  reader  to 
Hahnemann's  beautiful  treatise  :  "  How  is  it  possible 
that  small  homoeopathic  doses  of  a  highly  attenuated 
medicine,  should  still  possess  power,  great  power  ?  "* 
We  likewise  recommend  Dr.  Trink's  excellent  treatise 
in  opposition  to  Hahnemann :  Reflections  on  Doses,f 
and  Dr.  Gross'  reply.J 

We  beg  leave  here  to  record  our  own  opinion  about 
the  action  of  our 'doses,  which  is  sometimes  of  long 
duration,  and  sometimes  is  not  perceived  at  all.  Of  that 
action  Hahnemann  says  in  the  Chronic  Diseases :  § 
"  "This  is  not  one  of  those  propositions  which  can  be' 
comprehended  ;  nor  do  I  ask  that  it  should  be  blindly 
credited.  I  do  not  comprehend  it  either,  but  the  truth 
is  as  I  have  stated.  This  is  a  matter  of  experience  in 
which  I  have  more  confidence  than  in  my  own  com- 
prehension." The  experience  which  we  possess  of 
the  power  of  the  doses,  may  be  deemed  sufficient, 
and,  it  is  all  that  we  shall  know  about  it  for  some 
time  to  come.  However,  we,  no  more  than  others, 
have  been  able  to  resist  the  desire  which  is  inherent 
in  the  human  mind  of  explaining  every  phenomenon 
which  interests  man ;  and  inasmuch  as  it  cannot  be 
denied  that  the  power  with  which  homoBopathic  doses 
act,  is  a  most  interesting  and  remarkable  occurrence, 
we  have  tried  to  explain  it  to  our  mind  as  satisfactorily 
as  possible,  although  we  admit  that  our  explanation  to- 
gether with  all  others,  rests  upon  a  hypothetical  basis, 
having  more  or  less  probability  in  its  favour. 

It  is  well  known  both  to  allopaths  and  homoeopaths 
that  the  human  organism  cannot  be  invaded  by  a 
morbid  force,  be  this  either  spiritual  or  material,  unless 
the  organism  is  in  a  state  of  adaptation  to  that  force  or 
in  a  state  of  susceptibility  to  its  influence.  This  fact 
can  be  illustrated,  by  examples.  Epidemic  scarlet-fever, 
erysipelas,  measles,  etc.,  do  not  attack  anybody  who  has 

*  Materia  Med.  Pura,  by  Dr.  Hempel,  Vol.  IV. 
t  Annals  of  Horn.  Cliniq-ie,  Vol.  111.,  No.  2,  p.  127. 
j  Allg.  bora.  Zeit  ,  Vol.  I.,  p.  43. 
§  Chronic  Diseases,  Vcl.  I.,  by  Dr.  Hempel. 


72  INTRODUCTION. 

not  yet  had  those  diseases ;  we  frequently  see  one  or  two 
individuals  in  a  family  where  either  of  those  diseases 
prevails,  remaining  free  from  the  disease,  but  they  are 
attacked  by  it  when  the  disease  occurs  a  second  time  and 
and  when  the  organisms  of  those  individuals  are  more 
susceptible  to  it  than  they  were  during  the  first  invasion 
of  the  epidemic.  Not  all  persons  who  expose  them- 
selves to  the  contagiumof  itch  or  syphilis,  will  be  infect- 
ed by  it ;  such  an  infection  \vill  only  take  place  in 
persons  whose  organisms  are  predisposed  to  the  recep- 
tion of  the  miasm.  If  the  predisposition  of  the  organ- 
ism were  not  necessary  to  its  infection  by  a  conta- 
gium,  how  could  we  account  for  the  fact  that  of  ten 
persons  who  are  bitten  by  a  mad  dog,  only  two  or 
three  become  affected  with  hydrophobia. 

A  sick  organism  is  much  more  vividly  affected  by 
external  disagreeable  impressions  than  an  organism  in 
a  state  of  perfect  health,  which  may  be  left  entirely 
undisturbed  by  those  impressions.  The  sick  organism 
being  so  easily  irritated  by  the  least  disturbing  causes, 
it  requires  on  the  other  hand  very  little  to  affect  it 
favourably.  It  is  upon  this  fact  that  we  account  for 
the  efficiency  of  homoeopathic  doses.  The  homoeopath- 
ic agent  and  the  morbid  force  disturbing  the  organism 
in  a  similar  manner,  their  disturbing  influence  must 
be  directed  primarily  against  the  same  central  point 
in  the  organism,  and,  in  disease,  that  central  focus  must 
therefore  be  readily  influenced  by  the  homoeopathic 
agents,  so  that  the  natural  irritation  will  be  easily, 
thoroughly  and  permanently  counterbalanced  and  ef- 
faced by  the  artificial  influence. 

Although  Hahnemann  has  shown  that  the  inherent 
power  of  a  drug  is  only  properly  developed  by  the  dy- 
namizing process,  yet  we  believe  that  the  real  dy- 
namic force  of  the  remedial  agent  begins  to  act  only 
\vhen  it  meets  the  central  focus  of  the  disease,  to 
which  the  homoeopathic  agent  conjoins  itself  as  the 
seed  does  to  an  appropriate  soil ;  if  that  central  focus 
be  not  met,  the  dynamis  of  the  homoeopathic  agent 
remains  in  a  latent  state  and  the  disease  goes  on  in- 
creasingly ;  or  else  the  remedy  may  develops  its  own 


INTRODUCTION.  73 

pathogenetic  symptoms,  which  become  engrafted  upon 
the  disease  without  any  benefit  to  the  patient.  This 
takes  place  in  cases  where  the  remedy  is  not  homoe- 
opathic to  the  disease,  where  it  covers  a  few  symptoms 
only  \vithout  corresponding  to  the  fundamental  charac-»» 
ter  of  the  disease,  or  where  the  dose  was  too  powerful! 
or  the  patient's  sensibility  too  great. 

To  avoid  either  of  those  results  the  homoeopathic 
physician  ought  to  possess  a  perfect  knowledge  of 
disease,  in  order  to  be  able  to  distinguish  essential 
from  accidental  symptoms,  but  he  ought  likewise  to 
possess  a  complete  knowledge  of  the  symptoms  of  our 
drugs,  in  order  to  be  sure  that  the  remedy  he  selects  is 
the  true  homoeopathic  specific.  If  those  conditions  are 
fulfilled,  the  curative  reaction  of  the  organism  will 
seldom  fail  to  be  excited  in  such  a  degree  as  will  lead  to 
the  restoration  of  the  patient's  health  in  the  most  ex- 
peditious and  safest  manner. 

We,  no  more  than  Hahnemann,  comprehend  how 
medicines  can  act  for  so  long  a  period ;  and  yet  we 
sometimes  let  them  act  much  longer  than  Hahnemann 
did,  and  sometimes  we  give  them  more  frequently, 
even  the  antipsorics,  than  he  advises  in  the  Chronic 
Diseases.  On  that  subject  we  beg  leave  to  record  our 
opinion  as  follows: 

It  has  already  been  mentioned  that  the  action  of  the 
homoeopathic  agent  is  seen  most  brilliantly  when  it 
bears  directly  unon  the  central  focus  of  the  disease, 
which  must  always  occur  when  the  remedy  is  the  true 
homoeopathic  specific.  If  the  remedy  be  homoeopathic 
to  the  disease,  the  organic  vital  forces  will  be  power- 
fully roused  in  opposition  to  the  heterogeneous  influence 
of  the  drug.  The  vital  reaction  being  once  excited 
and  having  succeeded  in  overcoming  the  artificial  dis- 
turbance, it  does  not  at  once  compose  itself  to  a  state 
of  rest,  but  it  continues  active  until  the  normal  condi- 
tion of  the  affected  organs  shall  have  been  restored. 
It  is  for  this  reason  that  the  curative  reaction  sometimes 
continues  for  weeks  and  months,  provided  the  remedy 
was  perfectly  homoeopathic  to  the  disease.  The  cura- 
tive reaction  lasts  much  longer  in  a  chronic  than  in  an 
4 


74  INTRODUCTION* 

acute  disease ;  the  former  being  more  deeply  rooted 
than  the  latter.  The  duration  of'the  curative  reaction 
may  be  illustrated  by  the  vibrations  of  a  musical  cord* 
\vhich  continue  long  after  the  cause  which  excited 
them  has  ceased.  It  may  likewise  be  illustrated  by 
the  fact  that  a  long  and  progressively  increasing  dis- 
ease may  be  excited  by'a  momentarily  existing  cause 
ceasing  the  moment  after  its  influence  upon  the  organ- 
ism has  been  established. 

As  regards  Hahnemann's  views  about  the  selection 
of  the  remedy,  they  have  been  considerably  changed 
by  experience.  He  thought  that  the  medicines  which 
he  had  proved  first  were  more  suitable  to  acute  and  the 
so-called  antipsorics  to  the  chronic  diseases.*  Experi- 
ence however,  which  is  the  safest  guide  in  medicine, 
has  convinced  Hahnemann  and  all  homoeopathic  phy- 
sicians that  such  a  division  of  our  remedies  into 
antiphlogistics  and  antipsorics  is  not  founded  in 
Nature,  inasmuch  as  the  antipsorics  are  frequently 
used  in  acute  diseases,  such  as  Phosphorus,  Acidum 
phosp.,  Carbo  veg.  in  cholera  morbus,  and  the  anti- 
phlogistics in  chronic,  such  as  Chamomilla  in  cardial- 
gia,  Acidum  hydroc.,  Verbascum  in  chronic  affections 
of  the  larynx.  Hahnemann  being  convinced  that  his 
former  views  on  that  subject  required  modification, 
he  incorporated  a  number  of  his  first  remedies  in  the 
second  edition  of  his  Chronic  Diseases. 

In  regard  to  the  treatment  of  Chronic  Diseases  we 
refer  to  some  observations  which  have  been  communi- 
cated in  the  second  number  of  the  eighth  volume  of 
the  Archive,  p.  33,  and  which  are  still  valuable  to 
the  practitioner.  We  there  read  :  "  Every  physician 
knows  that  chronic  affections  in  their  incipient  stage 
are  so  little  troublesome  to  patients  that  they  do 
not  consult  their  physicians  until,  after  a  very  grad- 
ual and  sometimes  scarcely  perceptible  develop- 
ment, the  affection  breaks  forth  in  an  acute  form, 
acute  rheumatism,  acute  gout,  etc.  Although  these 

*  By  antipsorics  Hahnemann  understands  those  remedies  which  he  proved 
after  the  discovery  of  his  psora  theory  and  which  are  contained  in  the 
Chronic  Diseases. 


INTRODUCTION.  75 

acute-chronic  affections  depend  no  doubt  upon  a 
chronic  miasm,  yet  it  would  not  be  advisable  to  treat 
them  with  antipsorics  from  the  very  commencement,  for 
this  reason,  that  the  antipsorics  frequently  occasion 
a  considerable  aggravation  of  the  symptoms  in  the 
first  two  weeks,  which  it  is  very  difficult  to  counter- 
balance by  other  remedies.  The  vehemence  of  the  acute 
attack  ought  in  the  first  place  to  be  allayed  by  a 
remedy  which  does  not  properly  belong  to  the  class  of 
the  antipsorics,  and  after  the  disease  has  been  reduced 
again  to  its  former  condition,  then  the  antipsoric  treat- 
ment ought  to  commence.  After  having  instituted  a 
number  of  experiments  in  regard  to  the  best  mode  of 
treating  chronic  diseases,  we  have  adopted  the  follow- 
ing views  in  reference  to  that  subject :  Do  not  begin 
the  treatment  of  every  chronic  disease  with  an  anti- 
psoric, but  sometimes  with  one  of  the  former  remedies, 
especially  when  the  disease  had  been  successfully,  and, 
as  may  hence  be  inferred,  specifically  treated  with 
one  of  those  remedies  previous  to  the  antipsorics 
being  known.  Among  them  the  principal  are  the 
polychrests,  some  of  which  are  equal  to  the  antipso- 
rics in  the  treatment  of  chronic  diseases  ;  M*e  may 
mention  Belladonna,  Nux,  Ilhus,  Staphys.,  Asa.,  Dulc., 
Mezereum,  Sarsap.,  Ars.,  Coloc.,  Hepar,  Anac.,  Clem., 
Puls.,  Ignat.,  etc.* 

The  reviewer  of  my  first  edition  objects  to  the  last 
proposition  and  would  like  to  see  it  altered.  Numer- 
ous experiments,  however,  have  convinced  me  that  my 
opinion  is  not  altogether  incorrect.  Even  before  me 
many  physicians  have  objected  to  any  rigorous  line  of 
demarcation  being  drawn  between  antipsorics  and  the 
remedies  for  acute  diseases;  they  have  proposed  that 
remedies  should  be  administered  with  reference  to  the 
symptoms  independently  of  that  division.  I  propose 
the  same  thing,  viz.  that  no  remedy  which  has  been 
known  to  act  as  a  specific  curative  in  a  given  disease, 
be  discarded  until  we  know  a  substitute  for  that 
remedy  which  -will  act  still  more  specifically. 

*  Dulc.,  Mez.,  Sarsap.,  Ars  ,  Coloc.,  Hepar,  Anac.,  Clem.,  belong  to  the 
antipsorics. — HEMPEL. 


76  INTRODUCTION*. 

It  is  an  acknowledged  fact  that  antipsorics  are  the 
best  remedies  for  disorganizations  and  such  affections 
as  could  not  be  cured  by  any  of  the  non-antipsoric 
remedies,  or  when  these  are  not  indicated  in  the  pre- 
sent case.  In  all  such  cases,  the  treatment  ought  to 
be  commenced  with  Sulphur,  the  best  preparation  be- 
ing the  tincture  of  Sulphur,  one  dose  a-day  for  4,  6  or 
8  days  in  succession,  provided  the  Sulphur  is  at  all  in- 
dicated by  a  few  or  more  symptoms,  or  the  patient  has 
a  distinct  recollection  of  having  had  the  itch.  The 
Sulphur  may  be  continued  until  several  symptoms 
make  their  appearance  which  the  patient  has  not  yet 
felt  on  any  former  occasion.  After  the  action  of  the 
Sulphur  has  been  distinctly  perceived,  it  ought  to  be 
discontinued,  and,  as  soon  as  the  Sulphur  has  ceased 
to  act,  the  patient  ought  to  be  given  another  antipsoric 
which  is  most  homcEopathic  to  the  symptoms.  This 
will  act  with  so  much  more  certainty  and  success 
after  the  Sulphur  has  been  given.  This  second  anti- 
psoric has  likewise  to  be  repeated,  but  less  frequently 
than  the  Sulphur  ;  the  frequency  of  the  repetition  has 
to  be  left  to  the  judgment  of  the  physician.  If  a  well- 
chosen  antipsoric  should  not  act  as  well  as  the  phy- 
sician had  a  right  to  expect,  he  then  may  again  recur 
to  a  few  doses  of  Sulphur  to  secure  a  more  favourable 
reaction,  and  afterwards  give  the  next  suitable  anti- 
psoric ;  in  this  way  the  Sulphur  may  have  to  be  re- 
peated two,  three  or  four  times  during  an  antipsoric 
treatment.  In  spite  of  this  truly  scientific  proceeding 
in  the  treatment  of  inveterate  diseases,  especially  when 
disorganizations  have  already  occurred,  the  physician 
sometimes  fails  in  accomplishing  anything,  and  the 
disease  goes  on  in  its  course.  Under  these  circum- 
stances the  dose  has  to  be  increased,  which  is  some- 
times the  only  means  left  to  benefit  the  patient.* 

In  the  treatment  of  acute  diseases,  success  depends 
entirely  upon  the  proper  selection  of  the  homoeopathic 
agent ;  but  there  are  cases  in  which  the  ordinary 
specifics  have  no  effect.  This  deficient  action  of  the 

*  Under  these  circumstances  the  most  marked  success  lias  been  obtained 
from  the  highest  potencies. — HEMPEL. 


INTRODUCTION.  77 

remedial  agents  frequently  depends  upon  an  impover- 
ished, vital  force,  or  upon  an  excess  of  vital  energy 
in  one  or  the  other  part  of  the  disturbed  organism, 
owing  to  which  the  curative  reaction  is  either  entirely 
or  at  least  partially  prevented  ;  in  such  cases  the  pa- 
tient is  first  to  be  mesmerized,  after  which  the  homce- 
opathic  specific,  which  would  not  act  before,  will  be- 
come a  most  efficient  agent.  Sometimes  the  want  of 
action  depends  upon  a  latent  dyscrasia  having  been 
excited  by  the  acute  disease,  which  requires  a  suitable 
antipsoric  to  be  again  reduced  to  a  latent  state.  Sul- 
phur is  generally  the  best  antipsoric  to  be  employed 
for  such  purposes,  it  removes  the  symptoms  which  had 
appeared  in  company  with  the  acute  disease,  or,  at  any 
rate,  it  restores  the  original  character  of  the  acute 
disease,  and  enables  the  previously  employed  remedy 
to  exhibit  its  full  action. 

The  following  observations  relative  to  the  treatment 
of  acute  affections  may  conclude  our  general  remarks 
about  the  homcEopathic  treatment  of  disease.  If  no 
change  of  symptoms  occur  two,  or  at  most  four,  hours 
after  the  dose  has  been  taken  by  the  patient — provided 
the  dose  was  of  sufficient  magnitude — this  is  a  certain 
sign  that  the  remedy  is  not  homoeopathic  to  the  disease, 
and  that  another  more  suitable  remedy  requires  to  be 
selected.  But  if  an  improvement  commences  a  few 
hours  after  the  taking  of  the  first  dose,  if  the  conscious- 
ness becomes  freer,  the  sleep  is  more  quiet,  the  skin 
moist,  no  other  dose  or  remedy  ought  to  be  given  until 
the  improvement  ceases. 

In  acute  diseases  where  life  is  in  the  most  imminent 
jeopardy,  the  medicine  may  be  repeated  every  fifteen 
minutes,  half  hour,  hour,  or  every  two,  or  three  hours, 
provided  the  physician  is  sure  of  having  selected  the 
proper  remedy.  This  frequency  of  repetition  is  espe- 
cially admissible  in  inflammatory  affections,  asthmatic 
complaints,  typhoid  fevers,  dysentery,  cholera  and  dis- 
eases of  a  similar  kind,  etc.  The  attenuation  ought,  of 
course,  neither  be  too  high  nor  too  low. 

We  now  come  to  mention  the  $fth  fundamental 
principle  of  homosopathy,  which  is  just  as  important  as 


78  INTRODUCTION. 

it  is  characteristic  of  our  practice  ;  it  is  this,  that  no 
more  than  one  remedy  at  a  time  ought  ever  to  be  given. 
By  mixing  several  remedies  together,  in  old  school 
fashion,  the  peculiar  effects  of  each  are  easily  disturb- 
ed, or  even  neutralized,  or  a  compound  effect  results 
from  that  mixture  which  it  is  impossible  to  determine 
a  priori,  and  which  we  can  only  ascertain  by  proving 
the  mixture  upon  the  healthy  organism.  This,  how- 
ever, \vill  probably  not  be  undertaken  as  long  as  there 
are  simple  remedies  left  of  which  the  physiological 
action  upon  the  organism  remains  yet  to  be  ascertain- 
ed. If  the  homosopathic  physician  were  to  recom- 
mend, in  company  with  the  homoeopathic  agent  the 
use  of  herb-tea,  herb-bags,  fomentations,  injections 
or  ointments  composed  of  medicinal  herbs,  he  would 
commit  the  same  mistake  \vhich  we  censure  in  old- 
school  practice,  and  he  could  not  rely  upon  the  effect 
of  the  small  homoeopathic  doses. 

Some  homoeopathic  physicians  have  tried  to  mix  two 
remedies,  one  of  \vhich  seemed  homoeopathic  to  one 
portion  of  the  symptoms,  and  the  other  to  the  remain- 
ing portion  ;  but  the  results  did  not  answer  their  ex- 
pectations, and  all  good  homoeopathic  physicians  were 
soon  convinced  that  such  a  course  would  have  occa- 
sioned the  ruin  of  true  homoeopathy,  and  would  have 
degraded  our  practice  far  below  the  practice  of  the 
old  school. 

It  would  be  as  pernicious  both  to  our  patients  and 
practice,  to  mix  our  remedies,  as  it  is  useful  in  many 
complicated  cases,  to  use  two  remedies  alternately 
at  suitable  intervals.  This  alternation  may  be  mucn 
more  rapid  in  acute  than  in  chronic  diseases.  In 
the  former  the  power  of  a  dose  is  soon  spent,  in  the 
latter,  on  the  contrary,  the  functions  of  the  organism 
are  either  carried  on  naturally,  or  they  are  too  slow  or 
even  entirely  suppressed.  We  will  illustrate  this  by  a 
few  examples. 

Scarlet  fever  and  purpura  miliaris  are  frequently 
found  complicated  ;  to  the  former  corresponds  Bellad., 
to  the  latter  Acdfcite,  both  of  which  remedies  may  be 
given  in  alternation  every  three  hours,  to  the  great 


INTRODUCTION.  79 

advantage  of  the  patient.  Dulcamara  and  Belladonna 
may  be  advantageously  alternated  in  angina,  when 
either  of  those  remedies  seems  to  be  homoeopathic  to 
the  symptoms.  The  erethism  to  which  consumptive 
patients  are  liable,  frequently  requires  the  use  of  Aco- 
nite, Acid,  hydroc.,  Laurocerosus,  etc.,  as  intercurrent 
remedies,  and  it  is  good  practice  constantly  to  employ 
one  of  the  latter  remedies  in  alternation  with  the  prin- 
cipal specific  as  long  as  the  erethism  lasts.  In  croup, 
Aconite  and  Spongia,  or  Spongia  and  Hepar  have 
been  alternated  with  great  advantage  by  a  number  of 
physicians. 

The  sixth  fundamental  principle,  as  formerly  estab- 
lished by  Hahnemann,  is,  not  to  give  a  second  dose  of 
the  same  remedy  or  to  administer  a  different  remedy 
until  the  former  shall  have  spent  all  its  power.  He 
deduced  this  maxim  from  the  fact  that  many  remedies 
act  for  days,  weeks,  and  even  months.  Having  at  first 
an  implicit  faith  in  that  maxim,  homosopathic  physi- 
cians never  thought  of  modifying  it  in  the  least.  This 
maxim,  however,  being  an  important  rule  in  practice, 
a  number  of  experiments  were  instituted  to  verify  it, 
and  it  was  found  that  the  frequent  and  successive  repe- 
tition of  a  dose  of  the  same  remedy  was  not  only  use- 
ful but  necessary  to  a  cure.  Even  in  the  first  edition 
of  this  work  the  repetition  of  the  dose  was  adverted  to 
as  necessary  in  some  cases,  but  at  that  time  it  was 
considered  an  exception  to  the  rule.  A  repetition  of 
the  dose  was  considered  necessary  especially  in  those 
cases  which  improved  after  the  first  dose,  but  seemed 
to  relapse  into  their  former  condition  after  the  lapse  of 
a  few  days.  Recently  the  repetition  of  the  dose  has  be- 
come a  universally  acknowledged  rule,  and  even  those 
physicians  who  are  in  the  habit  of  using  the  highest 
potencies,  do  not  always  administer  the  whole  pellet  at 
once,  but  dissolve  it  in  water  and  give  one  spoonful,  or 
two  or  three  of  the  solution  for  several  days  in  succes- 
sion. The  necessity  of  repeating,  the  dose  in  many 
cases  having  been  keenly  felt,  and  that  necessity  having 
been  established  by  the  observations  of  a  number  of 
physicians,  attempts  have  been  made  to  regulate  that 


80  INTRODUCTION". 

repetition  by  rules.  For  instance,  it  is  necessary  to  re- 
peat the  dose  if  the  first  dose  diminishes  the  violence, 
without  changing  the  character  of  the  disease,  and  if 
the  violence  of  the  attack  ceases  to  diminish  after  a 
time.  If  a  second  dose  effects  no  farther  change  but 
simply  prevents  the  disease  from  returning  to  its  former 
violence,  this  is  a  certain  proof  that  the  organism  has 
become  accustomed  to  the  influence  of  that  medicine. 
If,  however,  that  same  medicine  continues  to  be  indi- 
cated, in  that  case  a  lower  potency  require*,  to  be  ad- 
ministered, and  to  be  continued  until  reaction  has 
evidently  set  in,  which  ought  not  to  be  disturbed  by 
another  dose.  If  the  reaction  should  cease  before  the 
cure  is  effected,  in  that  ease  either  the  same  or  another 
more  suitable  remedy  has  to  be  administered. 

It  is  universally  conceded  that  the  dose  ought  to  be 
much  less  frequently  repeated  in  chronic  than  in  acute 
diseases  where  the  vital  process  is  carried  on  much 
more  rapidly  than  in  the  former,  and  where,  conse- 
quently, the  vital  powers  are  much  more  speedily  ex- 
hausted. The  repetition  of  the  dose  cannot  be  deter- 
mined by  fixed  rules,  and  has  to  be  left  to  the  tact  and 
judgment  of  the  physician;  of  course  he  ought  to 
.  possess  the  talent  to  judge  with  discretion.  If  highly 
sensible  and  active  organs  are  affected,  the  dose  will 
have  to  be  repeated  more  frequently,  because  its  power 
will  be  spent  much  more  rapidly,  as  is  the  case  in  in- 
flammatory and  typhoid  diseases.  In  such  diseases  the 
effects  of  the  remedy  are  perceived  very  soon,  and  the 
dose  admits  of  a  speedy  repetition.  If  the  effects  are 
not  soon  perceived,  we  may  conclude  with  certainty, 
that  either  the  potency  or  the  remedy  was  badly 
selected.  In  chronic  affections  the  effects  of  the 
remedy  ought  to  be  perceived  in  forty-eight  or  at 
latest  in  seventy-two  hours ;  if  they  are  not,  the 
remedy  is  either  not  homoeopathic  to  the  disease  or 
the  potency  was  not  adapted  to  the  susceptibility  of 
the  organism. 

If  by  repeating  the  dose  an  essential  change  is 
effected  in  the  symptoms,  this  change  may  be  con- 
sidered a  proof  that  the  medicine  is  no  longer  homcEo- 


INTRODUCTION.  81 

pathic  to  the  disease  ;  if  circumstances  permit,  the 
exhibition  of  a  new  remedy  may  be  delayed  twenty- 
four  or  forty-eight  hours  ;  if  the  change  of  symptoms 
should  indicate  danger,  a  new  remedy  ought  to  be  ad- 
ministered immediately.  The  dose  ought  not  to  be 
repeated  \vhen  the  disease  passes  into  a  new  stage, 
for  instance,  in  scarlatina,  after  the  disease  has  as- 
sumed a  new  form  by  metastasis  ;  in  croup,  when  the 
disease  has  passed  from  the  inflammatory  stage  to  that 
of  effusion ;  *  in  smallpox,  when  the  suppurative  stage 
has  commenced,  etc.  These  new  forms  of  the  disease 
require  new  remedies,  which  are  to  be  repeated  if 
necessary. 

It  is  advisable,  however,  especially  in  chronic  dis- 
eases, not  to  continue  the  same  remedy  too  long,  even 
if  the  dose  be  changed,  lest  the  organism  should  be- 
come accustomed  to  its  influence,  which  cannot  be 
useful  in  the  treatment.  Instead  of  repeating  the 
same  remedy  too  often,  it  \vould  be  better  to  select 
another  remedy  which  should  be  as  nearly  as  possible 
homoeopathic  to  the  disease,  and  to  repeat  this  remedy 
at  suitable  intervals,  after  which  the  previous  remedy 
may  again  be  given.  We  do  not  admit  with  Rau  that 
in  acute  cases  the  higher  potencies  are  more  suitable 
on  account  of  their  action  being  more  speedy  and 
shorter  in  such  cases ;  for  it  is  known  by  experience 
that  the  higher  potencies  act  more  intensely  and 
longer  than  the  lower,  that  they  excite  the  curative 
reaction  of  the  organism  much  more  tardily  than  the 
lower  potencies,  and  are  on  that  account  much  better 
adapted  to  the  treatment  of  chronic  diseases. 

The  last  fundamental  principle  in  homoeopathic 
practice  is  the  diet  and  mode  of  life.  This  is  of  the 
utmost  importance,  considering  the  smallness  of  the 
dose,  which  ought  to  be  regulated  by  the  intensity  and 
general  character  of  every  case.  The  strictness  of 
the  homoeopathic  diet  is  appreciated  even  by  the  old 
school ;  it  is  estimated  even  beyond  its  merits,  for  our 

*  It  is  asserted  by  some  pathologists,  that  what  has  been  hitherto  considered 
different  stages  of  croup,  are  four  distinct  varieties  of  that  disease,  each  of 
which  requires  a  special  treatment;  and  lias  no  connection  with  any  of  the 
other  varieties. — See  Horn.  Examiner,  Vol.  IV.,  5. 

4'* 


82  INTRODUCTION. 

cures  are  attributed  to  it  exclusively.  There  is  no 
doubt  that  everything  which  might  exercise  a  medi- 
cinal influence  upon  the  organism  should  be  carefully 
avoided  during  homoeopathic  treatment,  lest  the  action 
of  the  small  doses  should  be  impaired.  Chronic 
patients  particularly  should  be  submitted  to  the  most 
rigorous  diet,  inasmuch  as  their  disease  is  frequently 
maintained  and  even  aggravated  by  faults  of  diet  or 
other  artificial  influences  which  might  be  avoided.  A 
rigorous  diet  is  sometimes  even  sufficient  to  restore 
the  organism  without  any  medicine ;  at  any  rate  the 
susceptibility  of  the  organism  to  the  action  of  the 
remedial  agent  is  heightened  by  keeping  the  organism 
free  from  all  stimulating  and  disturbing  influences. 
Every  intelligent  physician  will  at  once  perceive  that 
not  every  patient  can  be  submitted  to  such  a  rigorous 
diet,  and  that  a  man  of  sixty  years  for  instance,  who 
has  been  in  the  daily  habit  of  taking  coffee,  tea,  wine, 
brandy,  or  of  smoking  tobacco  and  using  snuff,  cannot 
be  suddenly  deprived  of  those  things  without  detriment 
to  his  organism.  Hahnemann  allowed  smoking  and 
snuff;  he  forbade  wine,  brandy,  and  coffee,  with  great 
severity.  This  seems  to  be  inconsistent,  and  leads  us 
to  suppose  that  in  a  more  advanced  age  we  may  ex- 
cept some  other  things  besides  tobacco  from  the  gene- 
ral rule  of  abstinence.  But  let  the  homoeopathic 
physician  beware  lest  he  should  be  too  lenient  in  pre- 
scribing a  proper  diet  to  his  patients,  and  let  him  be 
mindful  of  the  proverb  :  Give  him  an  inch  and  he  will 
take  an  ell. 

In  acute  diseases  the  diet  ought  still  to  be  much 
more  rigorous  than  in  chronic,  and  the  more  so  the 
greater  the  danger  and  the  more  rapid  the  course  of 
the  disease.  The  physician  will  not  find  it  difficult  to 
enforce  that  rigorous  diet  in  acute  diseases  where  the 
patient  has  scarcely  any  desire  for  anything,  and  the 
attendants  are  of  themselves  convinced  that  the  strict- 
est diet  is  of  the  utmost  consequence.  If  the  patient 
does  not  wish  to  eat  anything,  nourishment  ought  not 
to  be  forced  upon  him  ;  on  the  other  hand  he  ought  to 
be  allowed  to  quench  his  thirst,  for  which  purpose  the 


INTRODUCTION.  83 

patient  will  generally  prefer  cold  water ;  he  may 
drink  this  without  fear,  provided  he  does  not  drink  too 
much  of  it  at  a  time.  When  the  instinct  of  self- 
preservation  has  again  been  awakened,  the  internal 
sense  of  the  patient  is  for  him  such  a  sure  guide  in 
regard  to  those  things  which  he  ought  to  eat  and  not 
to  eat,  that  the  patient  should  not  be  refused  anything 
without  very  cogent  reasons. 


FEVER. 


GENERAL    REMARKS    ON    FEVER. 

§  1.  According  to  Hahnemann,  the  symptoms  of  a 
disease  are  the  only  portion  of  the  disease  of  which 
we  can  take  cognizance.  This  is  accomplished  by 
means  of  our  senses.  The  internal  nature,  the  essence 
of  a  disease,  cannot  be  known  with  certainty ;  it  can 
only  be  conjectured.  Hahnemann  considered  the 
usual  names  of  diseases  as  collective  names  for  very 
different  conditions  of  the  affected  organism  ;  accord- 
ing to  him  those  names  are  of  no  value  in  the  treat- 
ment of  disease.  He  considered  fever  a  purely 
dynamic  disturbance  of  the  vital  force,  affecting  both 
its  action  and  sensibility,  and  being  most  distinctly 
perceived  in  the  vascular  system.  The  principal  char- 
acteristic of  fevers  is  the  changeable  nature  of  their 
symptoms.  Reil  (On  the  Diagnosis  and  Treatment  of 
Fevers,  sec.  ed.,  Vol.  I.,  §  24,)  says :  "  Any  classification 
of  disease  is  the  work  of  man,  which  Nature  does  not 
always  confirm  ;  on  this  account  \ve  are  unable  to 
draw  a  definite  line  of  demarcation  between  fevers 
and  those  diseases  which  are  not  fevers."  Yon  Hilden- 
brand  expresses  the  same  idea  in  the  following  words : 
"  Logica  definitio  febris  dari  non  potest."  The  great 
difference  which  prevails  among  febrile  diseases,  and 
the  frequent  changes  occurring  in  the  symptoms  of 
the  different  kinds  of  fevers,  make  it  .very  difficult 
to  offer  a  definition  of  fever  that  will  be  applicable  to 
all  its  varieties.  We  are  not  prepared  to  believe  writh 
Eisenmann,  Henle,  and  others,  that  the  spinal  marrow 
is  the  focus  of  every  fever ;  we  believe,  however,  that 
it  is  that  focus  in  all  cases  where  spasmodic  symptoms 
of  any  kind  form  the  commencement  of  the  fever,  and 


FEVEB.  85 

the  fever  is  not  seen  in  a  dist'nct  form,  except  after 
the  spasmodic  symptoms  have  been  removed.  When 
spasms  occur,  the  spinal  and  cerebral  irritation  is 
evident ;  but  it  would  be  improper  to  assert  that,  be- 
cause such  an  irritation  exists  whenever  the  febrile 
paroxysm  is  accompanied  with  spasms,  the  spinal 
marrow  must  be  the  primary  seat  of  every  fever. 
This  cannot  be  admitted  as  long  as  we  do  not  possess 
more  data  to  base  such  a  doctrine  upon  ;  for  the  allo- 
pathic physician  such  an  admission  would  be  especi- 
ally hazardous,  inasmuch  as  it  would  mislead  him  in 
his  treatment. 

The  homoeopath  needs  not  to  embarrass  himself 
with  a  definition  of  fever  ;  he  is  satisfied  with  Hahne- 
mann's  view,  .which  neither  injures  nor  benefits  the 
treatment. 

§  2.  The  common  symptoms  of  fever  which  have  to 
be  regarded  as  a  reaction  of  the  organism  against  the 
morbid  cause,  are  :  Increased  frequency  of  pulse  and 
breathing,  not  depending  upon  an  accidental  cause, 
such  as  fast  running,  but  upon  a  disturbance  of  the 
vital  principle.  Increased  warmth  of  the  patient, 
although  the  temperature  of  the  surrounding  air  is  the 
same  as  before  the  attack ;  orgasm  of  the  skin,  which 
becomes  warm,  hot,  dry,  turgescent,  and  exhibits  a 
vivid  red  colour;  bright  redness  of  the. tongue  and 
mucous  membrane  of  the  mouth  ;  vivid  and  glistening 
redness  of  the  eyes,  etc.  Excessive  desire  for  drinks, 
with  dryness  of  the  mouth  ;  diminution  of  the  secre- 
tions and  excretions,  strong  odour  and  high  col  our  of  the 
former.  Alternation  of  warmth  and  coldness,  some- 
times at  regular  intervals.  The  above-mentioned 
complaints  are  accompanied  with  a  general  sick  feeling 
of  the  organism,  headache,  weariness  and  debility  of  the 
limbs,  arrest  of  the  animal  functions,  increased  sensi- 
tiveness of  the  organs  of  the  senses,  delirium,  spasms, 
great  restlessness,  and  in  general  various  kinds  of  dis- 
turbances indicating  a  powerful  excitement  of  the 
organism. 

However,  the  pathognomonic  symptoms,  which  have 
been  mentioned  in  the  preceding  paragraph,  would 
furnish  but  a  very  imperfect  diagnosis  if  the  physician 


88  FEVER. 

did  not  possess  the  requisite  talent  to  put  a  proper  esti- 
mate upon  the  concomitant  symptoms. 

§  3.  In  treating  fevers  it  is  of  importance  to  the 
homo3Opathic  physician  that  he  should  know  the  causes 
of  the  fever,  the  local  symptoms,  the  type,  duration 
and  period  of  the  paroxysm  ;  he  should  know  whether 
the  fever  is  continuous,  remittent,  intermittent,  or  alter- 
nating— that  is,  whether  it  occurs  alternately  with 
morbid  conditions  of  another  kind.  The  proper  ap- 
preciation of  these  characteristics  is  of  great  import- 
ance to  the  selection  of  the  remedy,  which  can  only 
cure  the  fever  if  the  group  of  symptoms  which  char- 
acterizes the  fever  is  likewise  peculiar  to  the  remedy ; 
in  proportion  as  the  remedy  corresponds  more  minutely 
to  all  the  peculiarities  of  the  disease,  the  cure  will  be 
effected  so  much  more  rapidly  and  permanently. 

§  4.  We  ought  not  to  pass  unnoticed  the  critical 
phenomena  which  are  observed  in  fevers.  Although 
we  do  not,  and  owing  to  our  different  treatment,  can- 
not attach  as  much  importance  to  them  as  the  physi- 
cians of  the  old  school  do,  yet  the  homoeopathic 
physician  ought  not  to  neglect  studying  the  phenomena 
by  which  a  crisis  is  generally  characterized,  inasmuch 
as  they  may  occur  to  him  just  as  well  as  to  an  allo- 
pathic physician,  and  he  might  be  misled  in  his  treat- 
ment if  he  did  not  know  them.  It  is  not  advisable  to 
endeavour  to  establish  such  critical  changes  by  arti- 
ficial means,  for  this  reason,  that  we  are  ignorant  of 
the  mysterious  processes  which  Nature,  untrammelled 
and  unbiassed  by  treatment,  establishes  in  disease  for 
the  production  of  such  changes.  But  suppose  we 
knew  both  the  process  which  Nature  adopts  in  their 
realization,  and  the  operation  of  the  remedy  which  is 
intended  to  bring  about  a  similar  result,  in  that  case 
it  would  nevertheless  remain  a  proceeding  of  highly 
questionable  propriety  to  substitute  an  incomplete  and 
often  dangerous  crisis,  obtained  by  artificial  means,  in 
the  place  of  those  critical  changes  which  indicate  a 
favourable  but  frequently  insufficient  or  even  power- 
less reaction  of  the  organism  against  the  disease. 
We  do  even  believe  that  those  critical  changes  may 
be  greatly  moderated,  or  even  subdued,  by  homoeo- 


FEVER.  87 

pathic  treatment,  without  the  curative  action  of  the 
drug  being  diminished  in  the  least.  Those  changes, 
when  fully  developed,  frequently  constitute  peculiar 
diseases,  which  the  physician  is  called  upon  to  treat 
and  to  remove.  This  being  our  view  of  a  crisis  in 
disease,  we  shall  treat  the  subject  a  little  farther  in 
detail,  and  shall,  at  the  same  time,  mention  the  thera- 
peutic measures  to  be  adopted  when  a  crisis  occurs. 

§  5.  Critical  symptoms  in  fevers  are :  excessive 
debility,  chills,  increase  of  heat,  orgasm,  vertigo, 
illusions  of  the  senses,  oppression,  twitchings  of 
the  muscles,  or  even  subsultus  tendinum,  delirium 
and  cold  sweats,  accompanied  by  an  unequal, 
often  even  intermittent,  double-beating,  frequent 
pulse  ;  these  symptoms  can  only  be  considered  critical 
when  they  occur  spontaneously,  without  having  been 
occasioned  by  hurtful  influences  at  a  period  when  a 
crisis  may  naturally  be  expected,  and  the  vital  forces 
are  not  depressed.  If  we  had  it  in  our  power,  by 
establishing  such  a  crisis,  to  restore  in  the  patient  the 
sensation  of  a  full  return  of  health,  it  would  be  foolish 
not  to  excite  such  a  short-lasting  struggle,  and  to  main- 
tain it  until  it  should  have  accomplished  its  object. 
Very  frequently,  however,  a  crisis  remains  incomplete, 
the  organism  makes  renewed  and  ineffectual  efforts  to 
complete  it,  and  the  result  of  this  struggle  is,  in  many 
cases,  the  transfer  of  the  disease  to  a  noble  organ, 
whereby  life  is  not  only  endangered  but  frequently 
terminated.  A  crisis  is  a  dangerous  occurrence  in 
other  respects  ;  owing  to  "the  general  erethism  of  the 
organism,  the  crisis  may  easily  be  disturbed,  in  conse- 
quence of  which  the  organism  may  relapse  into  the 
original  disease,  and,  being  already  exhausted  by  the 
first  attack,  would  be  much  more  dangerously  pros- 
trated by  the  second.  We  will  now  proceed  to  a  more 
detailed  consideration  of  the  critical  phenomena. 

§  6.  We  believe,  with  others,  that  a  critical  sweat  is 
a  decisive  sign  of  the  equilibrium  of  the  organism 
having  been  restored  in  fever,  when  the  sweat  is  pre- 
ceded by  several  cold  creepings  over  the  skin  or  itch- 
ing of  that  organ,  when  it  is  accompanied  by  a  soft, 


88  FEVER. 

undulating  pulse,  a  warm,  soft,  moist  skin  with  a  red- 
dish tinge,  when  it  covers  the  whole  body  uniformly, 
is  neither  too  profuse  nor  lasts  too  long  in  proportion 
to  the  intensity  of  the  fever ;  when  the  violence  of  the 
symptoms  abates  during  the  breaking  out  of  the  sweat, 
and  the  patient  feels  relieved.  Generally,  that  sweat 
occurs  as  a  result  of  the  homcBopathic  specific,  and 
ought  not  to  be  disturbed  in  any  way.  The  medicine 
should  be  stopped,  the  patient  should  be  covered 
neither  too  warmly  nor  too  slightly,  he  should 
remain  in  the  same  temperature,  and  keep  perfectly 
quiet.  If  the  breaking  out  of  the  sweat  should  have 
been  prevented,  or  the  swreat  itself  arrested  in  any 
manner,  and  if,  in  consequence  of  that  suppression, 
new  symptoms  should  have  made  their  appearance, 
in  that  case  the  physician  needs  not  to  expect  anything 
of  the  equilibrating  influence  of  the  sweat,  and  has 
at  once  to  exhibit  one  of  the  following  remedies  in 
accordance  with  the  symptoms  : — Puls.,  Dulc.,  Aeon., 
Cham.,  China,  Merc.,  Phosp.  ac.,  Sulp.,  and  several 
others.  If  the  sweat  be  too  copious,  if  the  patient 
feel  exhausted  while  it  occurs,  and  other  alarming 
symptoms  set  in,  the  medicine  has  not  been  well 
chosen,  and  another  remedy  has  at  once  to  be  admin- 
istered, either  for  the  purpose  of  terminating  the  sweat 
or  transforming  it  into  one  of  a  favourable  kind.  Tlje 
remedies  which  may  be  used  for  that  purpose  are  : 
Stannum,  Sulphur,  Merc.,  Acid.phosp.,  Arsen..Phosph., 
Ipec.,  Bryonia,  Verat.,  Lycop.,  and  some  others. 

If  the  symptoms  which  indicate  the  probable  occur- 
rence of  a  critical  sweat,  should  be  complicated  by  an 
anxious  restlessness,  oppression  of  the  chest,  panting 
breathing,  short  cough,  pains  in  the  limbs,  alternation 
of  shuddering  and  sweat,  etc.,  these  symptoms  may  be 
considered  the  precursors  of  a  rash  which,  if  the  symp- 
toms should  be  too  violent,  may  frequently  be  prevent- 
ed by  Aeon.,  Ipec.,  Bryo.,  Ars.,  Merc.,  each  remedy  to 
be  administered  in  accordance  with  the  indicating 
symptoms.  Sometimes,  however,  it  may  be  deemed 
advisable  to  favour  the  outbreak  of  the  sweat,  this  re- 
sult may  be  accomplished  by  Puls.,  Bryo.,  Cham., 


FEVER.  89 

Arsen.,  Acid,   phosp.,  Rhus,   Staphys.,   and  Sulphur, 
according  as  each  remedy  may  be  indicated. 

/  §  7.  The  critical  urine  is  likewise  seen  in  homoe- 
opathic treatment  and  is  a  so  much  more  favourable 
symptom  than  critical  sweat  as  it  is  not  accompanied 
with  phenomena  denoting  a  violent  irritation  of  the 
organism.  It  has  been  frequently  observed  that  a 
critical  urine  makes  its  appearance  even  after  the 
most  minute  doses  of  a  homoeopathic  specific,  showing 
that  the  reactive  powers  of  the  organism  are  constant- 
ly engaged,  during  a  well-regulated  treatment,  in  re- 
moving the  disease  and  that  these  favourable  critical 
changes  are  not  accomplished  by  large  doses  of  medi- 
cine. The  precursory  signs  of  a  critical  urine  are : 
slight  burning  and  pressing  in  the  urinary  passages, 
weight,  drawing  and  tension  in  the  lumbar  region, 
increased  desire  to  urinate,  increased  dryness  of  the 
skin,  and  increase  of  thirst,  all  these  being  symptoms 
which  do  not  necessarily  require  a  change  of  remedy. 
At  first  the  urine  exhibits  a  light  cloud  on  the  top  and 
in  the  middle  of  the  chamber  ;  the  cloud  lowers  itself 
more  and  more  day  after  day,  it  increases  and  grad- 
ually reaches  the  bottom  of  the  vase,  where  it  forms  a 
white,  slimy,  yellowish,  flocculent  sediment,  or  one 
which  is  light,  coherent  and  somewhat  elevated  in  the 
middle.  The  sediment  is  so  much  more  decisive«as  it 
settles  more  speedily  after  the  emission  of  the  urine 
and  is  more  copious ;  it  is  the  more  dangerous  the 

I  longer  the  urine  remains  turbid.     In  general  a  change- 

/  able  urine  is  a  very  dangerous  symptom,  as  it  shows 

f   a  deficient  reaction  of  the  organism. 

The  following  remedies  may  be  used  in  cases  of 
changeable  urine,  provided  the  other  symptoms  corres- 
pond :  Canthar.,  Colocynth.,  Digit.,  Sassap.,  Acid.  sulp. 
and  phosp.,  Dulcam.,  and  others;  when  the  urine 
deposits  a  mucous  sediment  which  does  not  reach  the 
bottom  of  the  vase :  Puls.,  Ant.  cr.,  Natr.  mur.,  Acid, 
nit.,  Dulc.,  Nux  v.,  Senega,  Sulp.,  Sassap.  Urine  with 
purulent  sediment  might  be  treated  with  Canth.,  Sep., 
Acid,  nitri.,  Puls.,  Lycop.,  Clematis  and  others,  [also 
Mercurius,  Cannabis,  and  Uva  ursi. — HEMPEL.] 


90  FEVER. 

§  8.  In  febrile  diseases  hemorrhages  are  favourable 
symptoms  and  may  be  considered  critical  even  by 
homoeopathic  physicians,  when  the  hemorrhage  pro- 
ceeds from  an  -organ  which  is  not  injured  by  it,  such 
as  the  nose,  womb,  anus,  or  if  the  hemorrhage  take 
place  in  young,  vigorous,  plethoric  subjects,  affected 
with  inflammatory  diseases,  and  the  congested  organ 
be  relieved  by  it  from  the  excess  of  blood.  Hemor- 
rhage frequently  takes  place  in  subjects  who  have  be- 
come plethoric  by  the  abuse  of  spirituous  drinks  or  in 
\vhom  the  choleric  temperament  predominates ;  or  in 
persons  in  whom  an  habitual  hemorrhage  which  is 
usually  left  to  nature,  has  been  suppressed  by 
accidental  causes.  We  frequently  see  hemorrhage 
taking  place  in  exanthematic  fevers.  If  the  hemor- 
rhage be  too  violent  and  exhaust  the  patient,  if  it 
proceed  from  the  nobler  organs,  the  lungs,  stomach, 
bladder,  if  the  blood  itself  be  decomposed,  in  all  such 
cases  the  hemorrhage  loses  its  critical  character  and 
ought  to  be  considered  a  dangerous  symptom  charac- 
teristic of  a  special  form  of  fever  and  requiring 
specific  remedies. 

Epistaxis  or  hemorrhage  from  the  nose  rarely  occurs 
suddenly ;  it  is  generally  preceded  by  more  or  less 
characteristic  complaints,  such  as  :  heat,  redness,  puffi- 
ness-  of  the  face,  red,  running  eyes,  scintillations  and 
flashes  before  the  eyes,  headache,  especially  in  the 
temporal  region,  vertigo,  humming  in  the  ears,  itching 
in  the  nose,  throbbing  of  the  temporal  arteries  and  the 
carotids,  distension  of  the  veins,  illusion  of  the  senses 
and  delirium  ;  all  these  symptoms  denote  a  congestion 
of  blood  to  the  head.  If  the  physician  is  able  to  remove 
those  symptoms  by  suitable  remedies  why  should  he 
not  do  so  ;  since  he  cannot  know  beforehand  whether 
the  hemorrhage  from  the  nose  will  be  of  a  critical  nature, 
why  should  he  delay  treatment  until  the  hemorchage 
has  actually  occurred  ?  According  as  the  constitution 
and  temperament  of  the  patient,  the  exciting  cause,  the 
concomitant  symptoms,  the  time  of  day,  etc.,  require, 
he  may  use  Aconite,  Bellad.,  Nux,  Crocus,  Carbo  veg., 
Cham.,  Arnica,  Pulsat.,  China,  Merc.,  Ranunc.  bulb., 


FEVER.  91 

Secale,  Sulphur,  or  some  other  remedy.  If  those 
symptoms  should  have  been  occasioned  by  a  remedy 
which  had  been  given  a  little  while  previous,  in  that 
case  they  have  to  be  met  by  a  suitable  antidote. 

If  the  hemorrhage  from  the  nose  has  already  set  in, 
then  one  of  the  following  remedies  is  indicated  and 
ought  to  be  selected  in  conformity  with  the  existing 
symptoms :  Aconite,  China,  Arnica,  Bryon.,  Pulsat., 
Ignat.,  Crocus,  Bellad.,  Carbo  veg.,  Sulphur,  and  a  few 
more.  If  the  hemorrhage  from  the  nose  continue,  and 
great  weakness,  fainting  fits,  collapse  and  other  symp- 
toms of  depletion  make  their  appearance,  it  is  perfectly 
proper,  even  for  a  homoeopathic  physician,  to  make  cold 
water  applications  to  the  genital  organs.  If  the 
blood  be  entirely  decomposed,  Kreosot,  China,  Conium, 
Rhus,  Arnica,  Carbo  veg.,  Ferrum  acet.,  Nitri.  acidum 
and  Acidum  sulphuricum  may  be  of  use,  each  remedy 
to  be  given  in  accordance  with  the  concomitant  symp- 
toms. 

A  similar  treatment  is  adopted  by  the  homoeopathic 
physician  in  congestion  of  the  womb  and  hemorrhage 
from  that  organ.  The  congestion  of  the  womb  is 
recognised  by  the  fulness,  tension,  uncomfortableness, 
the  dull  and  painful  drawing  along  the  groin  to  the 
ossa  pubis ;  by  the  peculiar  tension  in  the  lumbar 
region  ;  by  the  sensation  as  if  the  os  sacrum  had  not 
sufficient  firmness.  These  symptoms  are  frequently 
accompanied  by  a  burning  warmth  in  the  internal 
sexual  organs,  by  a  pressing  in  those  organs  as  if 
every  thing  would  fall  out ;  the  lips  of  the  vulva  are 
tumefied  and  there  are  occasionally  symptoms  of 
nymphomania.  The  symptoms  of  congestion  of  the 
uterus  occur  most  frequently  in  those  fevers  which 
arise  from  the  sexual  organs  ;  hence  they  occur  most 
frequently  during  confinement,  after  suppression  of 
the  menses,  or  when  the  sexual  organs  are  very 
irritable,  or  the  uterus  and  vagina  are  varicose. 
Symptoms  of  congestion  of  the  uterus  may  likewise 
occur  when  disturbances  of  organs  which  have  a 
sympathetic  relation  to  the  sexual  system,  are  accom- 
panied by  febrile  symptoms  involving  the  uterine 


92  FEVER. 

system  by  sympathy,  for  instance  affections  of  the 
breasts,  or  of  neighbouring  organs,  in  gastric  and 
haemorrhoidal  fevers,  or  in  fevers  depending  upon  con- 
gestions in  the  portal  system.  It  is  scarcely  necessary 
to  state  that  the  exciting  cause  of  the  disease  and  the 
disease  itself  have  to  be  considered  in  selecting  a 
remedy,  nevertheless  we  may  direct  the  attention  of 
the  practitioner  to  the  following  remedies  when  the 
congestion  of  the  uterus  is  characterized  by  the  above 
mentioned  symptoms :  Belladonna,  Hepar  sulp.,  Plat., 
Sulphur,  Mercurius,  Nux,  Bryon.,  China,  Ipec.,  Crocus, 
Murias  magnes.,  Calcar.,  Carbo  veget.,  Sabina, 
Ferrum,  Secale  corn.,  Ignat.,  and  Thuja. 

If  the  hemorrhage  is  inconsiderable  or  if  it  occurs 
at  the  regular  period  of  the  catamenia  and  affords 
relief  to  the  patient,  she  does  not  require  any  new 
remedy ;  but  if  the  hemorrhage  should  increase  to  a 
metrorrhagia,  the  following  remedies  deserve  parti- 
cular consideration :  Crocus,  Cham.,  China,  Ipec., 
Platina,  Ferrum,  Millefol.,  Hyosc.,  Stramonium, 
Bryon.,  Ignat.,  Sabina,  Secale  corn.,  Sulphuric  acid, 
Phosp.,  Calc.  carb.,  Nux  mosch.,  Ratanhia  (and  the 
tincture  of  Cinnamon, — HEMPEL).  It  is  always  under- 
stood that  each  remedy  should  be  administered  in 
strict  accordance  withxthe  symptoms. 

The  so-called  critical  "haemorrhoidal  flux  is  likewise 
preceded  by  symptoms  of  congestion  which  determine 
the  remedy  to  be  selected  ;  these  symptoms  are  :  pain 
in  the  small  of  the  back  as  if  it  would  break,  and  as  if 
there  were  no  power  in  it ;  desire  to  evacuate  the 
bowels  and  bladder  ;  burning  and  itching  of  the  anus 
and  of  the  haemorrhoidal  tumours.  If  those  symptoms 
occur  in  fevers,  the  following  remedies  may  be  em- 
ployed :  Nux,  Bellad.,  Ars.,  Sulphur,  Mercur.,  Ferrum, 
Ignat.,  Pulsat.,  Phosp.,  Lycop.,  Caps.,  Carbo  veg.,  Acid, 
mur.,  Acid,  sulp.,  and  Acid.  nitr.  A  very  troubtesome 
and  exhausting  symptom  in  congestion  of  the  anus,  is 
the  excessive  burning  pain  of  the  haemorrhoidal 
tumours.  That  pain  is  generally  caused  by  an  inflam- 
matory condition  of  the  swollen  tumours.  I  have  fre- 
quently succeeded  in  relieving  it,  at  least  for  a  few 


FEVER.  93 

moments,  by  repeated  smelling  of  Aconite,  without 
disturbing  the  action  of  the  principal  remedy. 

In  flowing  haemorrhoids  the  above  mentioned  reme- 
dies require  to.be  principally  employed. 

§  9.  As  regards  the  critical  discharges  from  the 
bowels  (critical  diarrhoea),  these  ought  never  to  be  left 
unnoticed  in  the  selection  of  a  new  remedy.  It  is 
impossible  to  point  out  with  unerring  certainty  those 
remedies  which  will  prove  the  most  efficient  in  those 
various  kinds  of  diarrhoea  for  which  the  organism 
may  be  predisposed  by  a  variety  of  diseases,  especially 
diseases  of  the  abdominal  organs.  Nevertheless  we 
will  mention  some  of  the  principal  remedies,  reserving 
to  us  the  privilege  of  speaking  of  them  more  in  detail 
when  we  shall  treat  of  the  special  treatment  of 
diseases. 

§  10.  The  same  remarks  which  we  have  offered  on 
the  critical  diarrhoea,  apply  to  the  so-called  critical 
vomiting.  This  change  which  is  considered  critical 
by  allopathic  physicians  and  which  is  ushered  in  by  a 
dirty  coating  of  the  tongue  and  a  tensive  oppression 
in  the  praecordial  region,  by  frequent  eructations,  in- 
clination to  vomit,  nausea,  great  restlessness  and 
anxiety,  frequent  shuddering  and  cold  sweat,  and  an 
irregular  and  intermittent  pulse,  requires  the  employ- 
ment of  a  specific  remedy.  This  symptom  occurring 
mostly  in  gastric,  bilious,  and'pituitous  affections,  for 
which  Nux,  Bryon.,  Pulsat.,  Antim.  crucf.,  Colchicum, 
Hellebore,  Platin.,  Secale  corn.,  Cuprum,  Veratr.,  Tart, 
emet.,  Ipec.,  Arseri1.,  Asar.,  are  the  best  remedies,  it  is 
not  to  be  wondered  that  precisely  those  remedies 
should  be  so  efficient  in  arresting  the  vomiting 
together  with  the  disease. 

§  11.  An  increased  secretion  of  mucus  in  the  lungs 
after  an  inflammatory  or  catarrhal  affection  cannot 
always  be  prevented,  even  under  the  best  treatment. 
That  secretion  is  owing  to  the  morbid  condition  of  the 
mucous  glands,  occasioned  by  the  previous  inflamma- 
tion. No  matter  what  shape  or  colour  the  expectora- 
tion may  assume,  ball-shaped,  thick,  coherent, 


94  FfiVEA. 

yellowish- white,  or  whether  it  be  considered  critical 
or  otherwise,  it  will  be  necessary  to  remove  it  by 
suitable  remedies,  lest  a  chronic  affection,  weakness, 
etc.,  should  be  entailed  upon  the  lungs  or  trachea, 
which  must  necessarily  be  the  case  if  the  expectoration 
is  suffered  to  remain  too  long.  Puls.,  Dulc.,  Squilla, 
Senega,  Ipec.,  Bryon.,  Stannum,  and  others,  are  the 
principal  agents  for  the  removal  of  such  an  expector- 
ation. 

§  12.  Critical  ptyalism  is  one  of  the  least  frequent 
phenomena  occurring  in  fevers.  It  is  seen  in  several 
kinds  of  typhoid  fever,  smallpox,  rash  or  quinsy,  and 
in  other  diseases  where  glandular  organs  are  affected. 
The  precursory  symptoms  of  ptyalism  are  said  to  be 
pain  behind  the  ears,  difficulty  of  swallowing,  conflu- 
ence of  saliva  in  the  mouth,  other  excretions  being 
suppressed  for  the  time.  Those  symptoms  indicate 
one  of  the  following  specifics: — Bellad.,  Hepar  sulp., 
Sulphur,  Mercurius,  Dulcam.,  Acidum  nitri.,  Tart, 
emet.,  Cantharides,  and  others. 

The  critical  changes  which  have  been  enumerated 
in  the  preceding  paragraphs  may  generally  be  consid- 
ered favourable  if  they  occur  at  a  period  of  the  fever 
which  has  the  character  of  a  critical  period,  if  they  are 
accompanied  by  an  essential  alleviation  of  the  symp- 
toms, or  if  they  do  not  depress  the  vital  energy ;  or 
lastly,  if  the  critical  reaction  of  the  organism  cannot 
be  ascribed  to  other  causes.  Under  homoeopathic 
treatment  that  critical  commotion  of  the  organism 
may  be  occasioned  by  too  large  a  dose  of  the  homoeo- 
pathic specific,  and  \vould  not  have  occurred  if  the 
dose  had  not  been  too  large. 

§  13.  It  is  just  as  important  for  a  homoeopathic  as 
it  is  for  an  allopathic  physician  to  know  the  general 
remote  causes  of  fever ;  without  that  knowledge  it  is 
scarcely  possible  to  establish  a  correct  diagnosis,  and 
to  treat  the  disease  successfully. 

The  exciting  causes  of  fever  are  very  various ; 
constitution,  sex,  age,  mode  of  life  and  occupation, 
the  natural  evolutions  of  the  organism,  may  be  such 


PEVER.  95 

causes ;  physical  exertions,  injuries  and  wounds,  in- 
ternal inflammations,  suppurations  and  ulcers,  etc., 
may  likewise  occasion  fever. 

Fevers  may  be  caused  by  external  influences  not 
depending  upon  any  innate  morbid  disposition  ;  such 
fevers  are  a  kind  of  poisoning  of  the  organism,  and 
may  be  considered  epidemic  and  contagious.  Such 
external  influences  are  : 

(1.)  The  atmospheric  air.  In  spring,  for  instance, 
when  the  weather  is  liable  to  sudden  changes,  and  a 
warm  atmosphere  frequently  alternates  with  rain, 
wind  and  cold,  catarrhal  and  rheumatic  fevers  are 
predominant ;  in  the  summer,  when  the  energy  of  the 
tody  is  depressed  by  hot  and  sultry  weather,  and  the 
digestive  and  assimilative  powers  are  weakened,  the 
organism  is  predisposed  for  bilious  and  gastric  fevers ; 
in  the  fall  the  sudden  succession  of  warm  days  and 
cold  nights  predisposes  man  for  pituitous,  typhoid, 
putrid,  and  other  kinds  of  dangerous  fevers ;  in  the 
winter  season,  fevers  have  generally  an  inflammatory 
character,  occasioned  by  the  cold,  dry,  raw,  and  cut- 
ting air.  Epidemic  malignant  fevers  generally  cease 
in  that  season.  An  atmosphere  filled  \vith  electricity, 
gases,  and  with  the  vapours  arising  from  marshes,  is 
likewise  favourable  to  the  occurrence  and  develop- 
ment of  fevers.  If  the  \veather  which  generally  pre- 
vails in  the  different  seasons,  deviate  greatly  from  its 
usual  state,  the  character  of  the  .fever  is,  of  course, 
correspondingly  modified.  Lastly ;  fevers  are  more  or 
less  influenced  by  the  stars,  which  affect  organized 
bodies  either  directly  or  indirectly,  by  means  of 
causes  or  conditions  controlled  by  the  influence  of  the 
heavenly  bodies.  The  state  of  the  weather,  for  in- 
stance, which  has  the  greatest  influence  on  the  animal 
organism,  is  regulated  by  the  heavenly  bodies.  Who 
does  not  know  the  influence  of  light,  heat,  sun  and 
moon,  upon  all  organic  beings  ? 

(2.)  Contagia  and  Miasmata.  Among  these  may 
be  numbered  poisonous  influences  arising  from  decay- 
ing plants  and  animals,  exhalations  of  plants  and 
animals  in  close  rooms,  becoming  deleterious  on  ac- 


96  FEVER. 

count  of  not  being  replaced  by  fresh  air.  If  one  man 
in  such  rooms  is  attacked  \vith  fever,  all  the  others 
are.  It  is  an  established -fact,  that  the  first  cases  of 
fever  are  occasioned  by  the  epidemic  miasm  ;  but  in 
the  patients  who  are  first  attacked  \vith  the  epidemic 
fever,  a  contagious  principle  is  afterwards  engendered 
capable  of  propagating  the  disease,  so  that  contagium' 
and  miasm  support  one  another. 

(3.)  Passions  and  emotions,  fright,  anger,  joy,  intox- 
ication, disturbance  of  the  mind  by  anxiety,  surprise, 
etc.,  and  in  general  violent  concussions  of  the  body, 
may  occasion  fevers.  Anger  may  occasion  a  bilious 
fever  and  inflammation  of  the  brain ;  silent  grief 
about  disappointed  love  may  bring  on  a  slow  typhus, 
and  the  most  malignant  fevers  may  be  caused  by  fear, 
anxiety,  fright,  constant  care  and  despondency. 

(4.)  Derangements  of  the  intestinal  canal,  produced 
by  overloading  the  stomach  with  things  which  are  not 
hurtful  in  themselves  ;  but  especially  by  taking  im- 
proper food  and  drinks,  large  portions  of  drugs,  etc., 
may  occasion  fevers.  Fevers  may  be  excited  by  eat- 
ing a  piece  of  fattened  goose,  duck,  or  pork,  or  by  eat- 
ing a  certain  kind  of  fish,  or  rather  the  spawn  of  that 
fish,  such  as  sturgeon,  barbel,  etc. ;  also  by  eating  crabs 
and  lobsters,  oysters,  clams,  and  mussels ;  by  spices, 
herbs,  roots,  mushrooms ;  barberries,  juniper-berries, 
bitter  almonds,  unripe  fruit,  may  likewise  excite  a 
febrile  sensation  in  the  organism.  Can  the  morbific 
power  of  spices  and  of  the  pastry  prepared  with  spices 
be  denied?  Although  we  are  by  no  means  opposed  to 
the  moderate  use  of  wine,  or  of  a  well-fermented  and 
pure  beer,  and  cannot  chime  in  with  those  who  con- 
demn those  beverages  as  injurious  to  health,  yet 
we  do  not  hesitate  to  denounce  any  abuse  which  is 
made  of  them,  as  well  as  the  use  of  hot,  spiced  wine, 
or  beer  mixed  with  stupefying  and  heating  herbs.  All 
such  beverages  have  a  tendency  to  produce  disease. 
Who  is  not  acquainted  with  the  febrile  conditions 
which  may  be  excited  by  the  abuse  of  China,  Mercu- 
rius,  Sambucus,  Valerian,  Chamomilla,  and  other 
remedies? 


FEVER.  97 

Want  of  those  things  which  are  necessary  to  sustain 
life. 

§14.  The  general  division  of  fever  into  classes 
is  of  no  essential  value  to  a  homeopathic  physician, 
as  that  classification  depends  principally  upon  the 
arbitrary  disposition  and  the  individual  views  of 
physicians.  All  fevers,  without  exception,  have  been 
classed  according  to  that  part  of  the  system  which  is 
the  primary  seat  of  the  affection,  or  according  to  their 
type  and  course ;  such  a  classification  is  both  incom- 
plete and  insufficient  in  practice.  In  one  word  :  there 
is  no  isolated  form  of  fever;  every  fever  affects 
primarily  one  or  the  other  organ,  the  brain,  the 
spinal  marrow,  the  ganglionic  system,  the  lungs,  the 
abdominal  organs,  the  skin,  the  mucous  membranes  of 
the  air-passages,  etc. ;  hence  every  fever  is  one  of  a 
different  kind,  the  difference  being  founded  both  in  the 
nature  of  the  affected  organ  and  in  the  character  of  the 
fundamental  affection.  Owing  to  the  great  variety  of 
the  febrile  symptoms,  it  is  impossible  to  class  fevers 
according  to  determinate  forms.  The  only  classifica- 
tion possible  is  one  of  the  general  phenomena  occurring 
in  the  various  kinds  of  fever.  Every  particular  group 
of  those  phenomena  can  easily  be  named  by  the 
physician  for  his  own  gratification  and  that  of  the 
attendants  of  his  patient,  and  can  easily  be  classed 
provided  the  organ  which  is  affected,  and  the  manner 
in  which  it  is  affected,  are  considered.  It  is  scarcely 
necessary  to  state  that  the  treatment  ought  not  to  be 
based  upon  the  mere  name. 

According  to  their  characters,  fevers  might  therefore 
be  divided  into 

(a.)  Synochal,  sthenic,  inflammatory,  arterial  (Syno- 
cha ;  synochal  reaction,  according  to  Canstatt).  This 
kind  of  fever  is  characterized  by  great  heat,  glowing, 
hot,  and  dry  skin;  accelerated,  full,  hard,  tight,  some- 
times subdued  pulse ;  distinct  beating  of  the  carotids, 
and  temporal  arteries  ;  bright-red,  frequently  white- 
coated,  and  mostly  dry  tongue  ;  hot  breath  and  hot 
mucous  membrane  of  the  mouth  ;  great  thirst ;  delay- 
ing or  suppressed  stool ;  bright-red,  fiery  and  burning 
5 


98  FEVER. 

urine,  depositing  a  sediment.  Violent  restlessness; 
painful  sensation  of  debility ;  frequently  the  patient 
experiences  violent  headache,  especially  in  the  occiput, 
sleeplessness,  delirium,  sensibility  of  the  organs  of 
sense.  Glistening  eyes.  The  phenomena  of  the  fever 
scarcely  ever  remit. 

(b.)  Synochus  (erethic  reaction  according  to  Can- 
statt).  This  is  a  form  of  fever  occupying  a  middle 
rank  between  synocha  and  typhus,  without  inclining 
to  either  side  except  when  the  fever  lasts  any  length  of 
time,  or  when  the  fever  patient  is  constantly  exposed  to 
hurtful  influences,  in  which  case  the  erethic  form  may 
pass  over  either  into  the  synochal  or  the  typhoid.  Ere- 
thismus  is  characterized  by  moderate  heat  and  a  slight 
exhalation  from  the  skin  ;  the  pulse  is  full,  accelerat- 
ed, but  neither  hard  nor  tight ;  the  tongue  is  slightly 
coated  and  moist ;  thirst  is  moderate  ;  the  al vine  evacu- 
ations are  not  entirely  suppressed  ;  the  urine  exhibits  a 
slightly  reddish  tinge.  The  general  strength  of  the  or- 
ganism is  but  slightly  affected  by  this  febrile  form,  which 
is  moreover  characterized  by  distinct  intermissions. 

(c.)  The  typhoid  form  is  a  peculiar  affection  of  the 
nervous  system,  disturbing  the  equilibrium  of  the 
vital  energies  which  is  maintained  by  the  nerves.  In 
real  typhus  the  functions  of  the  brain  and  nerves  are 
entirely  prostrated ;  the  strength  of  the  patient  fails 
visibly  and  there  is  a  tendency  to  disorganizations  and 
to  decomposition  of  animal  matter.  Typhus  is  cha- 
racterized by  irregular  and  violent  manifestations,  and 
by  illusions  of  the  senses,  muscular  debility,  exhaus- 
tion, but  neither  paralysis  nor  complete  prostra- 
tion. 

Canstatt  considers  typhus  as  a  variety  of  synocha 
and  synochus.  According  to  him  there  is  another 
distinct  form  of  fever,  which  we  on  the  contrary  con- 
sider as  a  termination  of  one  of  the  preceding  forms  ; 
this  is 

(d.)  Torpor.  Torpor  is  characterized  by  a  collapse 
of  all  the  organs  ;  pale,  cold,  dry  skin  which  is  liable 
to  break ;  dry  and  cracked  mucous  membrane  of  the 
mouth ;  frequently  a  disagreeable,  pricking  heat  of  the 


FEVER.  99 

skin,  or  else  cold,  clammy  sweats  ;  colliquative  sweats 
and  diarrhoea ;  collapse  of  the  features,  faint  eyes  ; 
sudden  emaciation ;  pulse  frequent,  quick,  empty, 
small,  easily  compressible ;  hemorrhage,  petechise, 
ecchymosis ;  speedily  increasing  prostration  of 
strength ;  excessive  muscular  debility,  tremor,  subgul- 
tus  tendinum,  delirium,  paralysis.  There  is  a  striking 
opposition  between  the  objective  and  the  subjective 
symptoms ;  for  instance,  the  patient's  tongue  is  dry 
and  yet  he  is  not  thirsty  ;  his  skin  is  cold  and  yet  he 
complains  of  a  glowing  heat ;  illusory  strength,  etc. 

With  respect  to  their  type,  those  different  forms  of 
fever  may  be  divided  into  continuous,  remittent,  or  in- 
termittent, irrespective  of  their  fundamental  character. 
Continuous  fevers  are  such  as  exhibit  the  same 
phenomena  during  their  whole  course  and  rage  with 
the  same  intensity  from  the  commencement  of  the  dis- 
ease to  its  crisis.  Fevers  are  called  remittent  when 
they  exhibit,  it  is  true,  the  same  phenomena  during 
their  course,  but  with  a  periodical  increase  and  de- 
crease of  intensity.  Intermittent  fevers  are  such  as 
are  characterized  by  remissions  of  a  definite  or  in- 
definite length,  during  which  the  patient  sometimes 
appears  perfectly  healthy. 

Fevers  may  likewise  be  divided  into  sporadic,  en- 
demic, epidemic,  and  still  other  classifications  might 
be  established,  which,  having  no  practical  value,  are 
here  omitted.  We  content  ourselves  with  recalling  to 
the  minds  of  our  readers  what  has  been  said  page  41 
about  the  influence  of  the  permanently  prevailing,  en- 
demic or  epidemic  character  of  disease  in  a  certain 
region  upon  any  of  the  above  mentioned  forms  of 
fever ;  this  influence  deserves  the  closest  attention  in 
the  selection  of  a  remedial  agent  and  is  greatly  con- 
cerned in  the  ultimate  result  of  the  treatment. 

§  15.  To  establish  a  prognosis  in  fevers,  is  not  so 
very  easy,  inasmuch  as  the  momentary  indications, 
•which  are  frequently  deceptive,  are  by  no  means 
sufficient ;  a  prognosis  which  is  to  be  well  founded  and 
to  bear  the  highest  character  of  probability,  must  be 
based  upon  a  correct  estimate  of  all  the  circumstances 


100  FEVER. 

and  of  the  whole  image  of  the  disease,  upon  a  careful 
consideration  of  the  constitution,  disposition,  age  and 
external  condition  of  the  patient,  of  the  state  of  the 
weather,  of  the  season,  and  the  simple  or  complicated 
character  of  the  fever ;  a  good  deal  of  discretion  is  re- 
quifed  to  establish  a  good  prognosis.  Although  it  is 
impossible  to  foretell  the  issue  of  the  fever  at  the  very 
commencement  of  the  disease,  inasmuch  as  the  practi- 
tioner cannot  possibly  foresee  all  the  hurtful  influences 
which  may  complicate  the  course  of  the  disease  and 
interfere  with  the  treatment :  yet  the  homoBopathic 
physician,  confiding  in  his  therapeutic  law  by  virtue  of 
\vhich  the  well-chosen  homoeopathic  specific  will  act 
directly  upon  the  focus  of  the  disease  and  excite  a 
corresponding  curative  reaction  in  the  organism,  is 
enabled  to  prognosticate  with  tolerable  certainty  the 
termination  of  the  disease,  provided  the  above  men- 
tioned conditions  of  a  well-founded  prognosis  are 
fulfilled. 

The  prognosis  is  generally  favourable,  when  the  pa- 
tient has  a  vigorous  constitution  and  has  led  a  regular 
mode  of  life  ;  when  the  pulse  is  regular,  soft,  not  too 
frequent ;  when  the  breathing  becomes  freer  and  more 
regular ;  when  the  nervous  system  is  but  little  affected 
and  the  expression  of  the  countenance  is  natural ;  when 
the  general  and  especially  the  muscular  strength  is 
good ;  and,  lastly,  when  the  secretory  and  excretory 
functions  are  not  interrupted. 

The  prognosis  is  unfavourable  when  the  constitution 
of  the  patient  has  been  weakened  by  former  excesses 
or  by  violent  diseases,  when,  therefore,  the  strength  of 
the  patient  must  be  greatly  prostrated  and  the  reaction 
very  deficient ;  when  the  pulse  is  very  frequent,  weak, 
and  irregular ;  when  the  nervous  system  is  violently 
affected,  the  patient  is%  delirious,  and  the  hands  and 
tongue  tremble ;  when  there  is  subsultus  tendinum, 
floccitation,  hiccough.  It  is  likewise  an  unfavourable 
symptom,  when  the  patient  remains  extended  on  his 
back  without  ever  changing  his  position,  or  when  he 
settles  downward  in  his  bed.  Unfavourable  symptoms 
are  likewise  :  general  apathy ;  involuntary  emission  of 


FEVER.  101 

urine  and  involuntary  alvine  evacuations  ;  retention  of 
urine ;  complete  alteration  of  the  expression  of  coun- 
tenance (hippocratic  countenance) ;  convulsions  ;  loss 
of  sight ;  dropping  of  the  lower  jaw ;  irregular  breath- 
ing when  there  is  no  particular  affection  of  the  chest ; 
hurried,  superficial  breathing,  interrupted  by  occasional 
sobs ;  difficult  deglutition,  or  a  noise  when  swallowing, 
as  if  the  swallowed  substance  fell  into  the  stomach  ; 
cold  extremities,  with  cold  clammy  sweats,  etc. 

There  remains  to  be  stated,  that  the  occurrence  of 
only  one  unfavourable  symptom  does  not  constitute  an 
unfavourable  prognosis,  but  the  prognosis  is  unfavour- 
able when  several  of  the  aforesaid  phenomena  occur 
simultaneously. 

§  16.  Fevers  may  terminate  in  three  different  ways. 
These  terminations  are,  (a,)  recovery ;  (b,)  passage 
into  another  disease;  (c.)  death.  The  fever  terminates 
in  health  when  it  runs  through  its  course  regularly, 
when  the  critical  changes  occur  regularly,  are  duly  ap- 
preciated by  the  physician,  and  are  not  disturbed  by 
external  pernicious  influences  ;  when  the  constitution 
of  the  patient  has  not  been  weakened  by  other  causes 
and  the  more  important  organs  have  not  been  dis- 
turbed. We  frequently  notice  the  fact,  that  patients 
who  recover  from  a  fever,  feel  better  after  the  fever 
than  they  did  before.  The  fever  passes  into  another 
disease  when  the  favourable  conditions  which  have 
been  mentioned  in  the  preceding  paragraphs,  do  not 
occur.  Either  the  whole  character  or  only  the  exter- 
nal form  of  the  disease  is  changed  ;  or  else  the  disease 
invades  a  totally  different  part  of  the  organism  (meta- 
stasis), or  it  assumes  a  new  form  by  metaschema- 
tismus.  Death  is  to  be  prognosticated  when  the 
functions  of  a  noble  organ  have  been  disturbed,  in 
consequence  of  inflammatory  affections,  disorganiza- 
tions (a  cure  is  frequently  effected  under  those  cir- 
cumstances, by  homceopathic  treatment),  suppuration, 
gangrene,  or  in  consequence  of  a  complete  prostration 
of  strength,  and  consequent  cessation  of  the  organic 
functions. 

§  17.  It  would  be  a  foolish  undertaking  to  indicate 


102  FEVER. 

a  general  method  of  treating  fevers  according  to  ho- 
moeopathic principles ;  it  would  be  a  useless  filling  up 
of  space,  inasmuch  as  no  physician  would  venture  to 
prescribe  a  single  remedy  without  having  carefully 
examined  the  group  of  symptoms  to  which  the  remedy 
is  required  to  correspond.  It  is  almost  superfluous  to 
remark  that  a  cure  according  to  homoaopathic  princi- 
ples cannot  be  effected  unless  the  pathogenetic  effects 
of  the  remedial  agent  are  entirely  similar  to  the  per- 
ceptible phenomena  of  the  disease.  Ebermaier  says, 
in  his  Clinical  Pocket-Manual :  "Those  physicians 
have  been  most  successful  in  the  treatment  of  fever 
who  have  employed  the  simplest  methods  of  cure,  no 
matter  how  frequently  the  epidemic  diseases,  the 
habitual  morbid  influence  of  a  region,  and  the  methods 
of  treatment  may  have  changed."  Is  there  a  simpler 
and  at  the  same  time  more  natural  method  of  cure 
than  homoeopathy,  which  accomplishes  so  much  with 
simple  means  specifically  adapted  to  each  single  case. 
An  important  object  in  the  treatment  of  fever  is  a 
suitable  diet,  which  we  mention  here  generally,  and  to 
which  we  shall  refer  in  our  chapters  on  the  special 
treatment  of  fever.  The  physician  will  have  to  exer- 
cise his  own  discretion  in  adapting  it  to  the  wants  of 
the  patient  in  every  single  case.  Fever  patients  gene- 
rally use  but  few  things,  but  every  thing  which  the 
patient  ought  to  do  and  not  to  do,  requires  to  be  care- 
fully stated.*  The  first  thing  \vhich  the  physician  has 
to  attend  to,  is  the  patient's  habits ;  these  have  to  be 
duly  considered  in  prescribing  a  diet  for  the  patient. 
The  patient  ought  not  to  be  removed  from  a  bed  to 
which  he  is  accustomed,  nor  ought  he  to  be  transported 
into  a  different  bedchamber;  if  he  has  been  accustomed 
to  quiet,  let  quiet  be  preserved  ;  if  he  has  lived  amidst 
noise  and  prefers  it,  let  him  continue  the  enjoyment  of 
it ;  if  the  patient  has  favourite  drinks,  such  as  brandy, 
wine,  coffee,  etc.,  the  physician  has  to  consider  the  age 
of  the  patient,  and  the  length  of  time  during  which 
those  beverages  have  been  his  favourite  and  habitual 

*  See  Dietetic  Rules  for  the  Sick,  etc.,  by  Dr.  F.  Hartmann,  Dresden  and 
Leipsic. 


FEVER.  103 

drinks ;  and  the  physician  will  determine  accordingly 
whether  the  patient  can  be  suddenly  deprived  of  them 
without  injury.  In  fevers  the  patients  do  not  find  it 
very  difficult  to  abstain  from  those  things,  as  there 
exists  generally  an  aversion  to  them.* 

The  temperature  has  to  be  carefully  regulated 
agreeably  to  the  feelings,  habits,  and  wishes  of  the 
patient,  and  in  accordance  with  the  nature  of  the  fever 
and  the  periods  when  it  occurs.  In  fevers  which  are 
characterized  by  an  undue  degree  of  heat,  the  room 
ought  to  be  kept  cool,  in  order  to  avoid  increasing  the 
oppression  and  anxiety  of  the  patient  by  an  excess  of 
artificial  heat ;  if  the  fever  heat  abates,  the  tempera- 
ture of  the  room  may  be  elevated  in  proportion.  The 
temperature  of  a  sick  room  ought  never  to  be  below 
25°  Fahrenheit,  nor  above  45°  ;  the  best  temperature 
is  between  35°  and  38° ;  if  then  the  room  appear  too 
cold  to  the  patient,  he  may  have  an  additional  cover- 
ing. The  air  in  the  sick-room  ought  to  be  dry  and 
pure.  Rooms  in  a  recently  built  house,  or  which  have 
been  recently  whitewashed  are  not  suitable  for  fever 
patients,  as  they  are  too  damp  and  therefore  make  the 
air  impure  by  the  vaporous  exhalations  from  the 
walls  ;  the  air  is  likewise  made  impure  by  hard-coal 
or  peat  fire,  by  coal  burning  in  an  open  furnace,  by 
drying  linen,  hard  or  pine  wood,  or  by  keeping  in  a 
room  flowers  and  vegetables  that  have  a  strong  smell ; 
by  fumigations  with  substances  that  are  more  or  less 
medicinal ;  even  fumigations  with  vinegar  cannot 
always  be  admitted  under  homoeopathic  treatment, 
because  vinegar  antidotes  many  vegetable  medicines 
and  must  therefore  possess  medicinal  virtues.  All 
these  things  have  to  be  avoided;  the  lighting  of  a 
sulphur-match  has  likewise  to  be  avoided  lest  the 
action  of  the  homoeopathic  agent  should  be  disturbed. 
A  moderate  degree  of  light,  in  the  room,  is  likewise 
essential  to  the  comfort  and  even  the  cure  of  the  fever 

*  Some  persons  are  accustomed  to  the  use  of  things  which  are  injurious  to 
them,  for  instance  the  use  of  coffee,  tea,  tobacco,  etc.  The  use  of  any  such 
things  is  to  be  positively  interdicted  during  treatment,  and  is  to  be  permitted 
only  if  the  patient  experience  pleasing  effects  from  them. — HEMFEL. 


104  FEVER. 

patient ;  if  the  eyes  be  very  much  inflamed  and  sen- 
sitive to  the  light,  or  if  the  light  increase  the  ir- 
ritation of  the  brain,  the  room  ought  to  be  kept 
dark. 

Inasmuch  as  the  doors  of  the  sick-room  require  to  be 
closed  in  order  to  prevent  currents  of  air,  it  is  impor- 
tant that  the  air  should  be  occasionally  renewed  by 
opening  the  windows  or  by  some  other  mode  of  arti- 
ficial ventilation.  This  renewal  of  the  air  requires  to 
be  repeated  in  proportion  as  the  room  is  lower  and 
smaller. 

§  18.  The  nourishment  which  we  permit  our  patient, 
likewise  depends  upon  the  nature  of  the  fever.  The 
fever  patient  having  generally  no  appetite  for  any 
solid  food,  we  need  not  apprehend  that  he  will  aggra- 
vate his  sufferings  by  an  error  in  diet ;  nevertheless 
it  is  important  that  whatever  nourishment  the  patient 
does  take,  should  be  carefully  selected.  If  he  should 
express  an  irresistible  desire  for  one  or  the  other  kind 
of  nourishment,  the  demands  of  nature  must  be  care- 
fully observed,  and  the  patient  must  neither  be  flatly 
refused  what  he  desires  to  have,  nor  ought  he  to  be 
persuaded  to  take  more  of  it  than  he  wants.  The 
fever  patient  generally  desires  such  kinds  of  food  or 
beverage  as  will  palliate  his  sufferings  ;  the  substances 
which  the  patient  desires,  are  not  so  much  medicinal 
as  necessary  to  satisfy  a  want.  If  the  cure  of  the  dis- 
ease should  be  retarded  by  the  moderate  enjoyment 
of  those  things  the  damage  will  be  easily  repaired  or 
even  outweighed  by  the  new  energy  imparted  to  the 
vital  forces  by  the  homoeopathic  remedial  agent,  and 
by  the  refreshing  delight  and  invigoration  which  the 
patient  experiences  from  enjoying  the  desired  food  or 
beverage.* 

The  fever  patient  eats  only  when  he  is  hungry,  and 
no  more  than  is  necessary  to  satisfy  his  appetite.  The 
general  rule,  however,  is,  that  the  patient  ought  to  eat 
little  and  only  light  food.  The  patient  will  not 
frequently  desire  warm  food ;  if  he  should  desire  any, 

*  See  Organon,  §  265  and  266. 


FEVER.  105 

he  may  take  a  little  warm  panado,  or  a  light  broth 
with  grits,  barley,  rice,  sago,  salep,  oatmeal,  oatmeal- 
cake.  If  the  fever  be  not  very  violent,  the  broth  may 
be  a  little  stronger,  and  the  patient  may  even  he  per- 
mitted a  dish  of  light  meat,  venison,  poultry,  which  is 
not  too  young,  a  piece  of  delicate  beef,  in  company  with 
either  of  the  above  vegetables.  In  proportion  as  the 
fever  decreases,  and  the  appetite  of  the  patient  re- 
turns, he  may  be  allowed  green  vegetables,  such  as : 
cabbage  of  various  kinds,  savoy,  cauliflower,  peas, 
carrots,  green  beans,  soft-boiled  eggs,  and  the  above- 
mentioned  dishes  of  rice,  barley,  etc.,  with  the  yolk  of 
an  egg,  may  likewise  be  allowed. 

The  best  kind  of  food  in  every  stage  of  the  fever  is 
undoubtedly  fruit.  Among  the  apples,  Spitzenberg, 
pippins,  and  love-apples,  are  undoubtedly  the  best  for 
the  patient,  especially  when  prepared  as  a  marmalade  ; 
he  may  likewise  eat  pears,  prunes,  either  fresh  or 
dried,  stewed  and  preserved  without  spices;  sweet 
cherries,  grapes,  strawberries,  peaches,  apricots, 
oranges,  figs,  melons,  pineapple.  Of  course  all  those 
various  kinds  of  fruit  ought  to  be  enjoyed  writh  moder- 
ation, lest  the  saccharine  matter  which  they  contain 
should  accumulate  in  too  large  a  quantity  and  give 
rise  to  flatulence,  which  might  become  very  trouble- 
some and  increase  the  fever.  In  erethic  fevers,  with 
disposition  to  diarrhffia,  the  physician  will  have  to  be 
very  cautious  in  recommending  the  use  of  fruit ;  in 
many  cases  that  use  will  have  to  be  interdicted 
entirely.* 

v§  19.  The  beverage  of  fever  patients  who  frequently 
suffer  with  burning  thirst,  deserves  particular  consid- 
eration. It  is  inexpedient  to  give  the  patient  no  other 
but  warm  drinks,  for  these  do  not  always  quench  his 
thirst.  But  it  would  be  just  as  improper  to  give  the 
patient  iced  water  or  other  icy-cold  drinks ;  a  medium 
temperature  is  the  best ;  let  the  drinks  which  the 
patient  takes  be  cool,  but  neither  warm  nor  icy  cold. 

*  Raw  fruit  of  any  kind  is  hurtful  in  most  cases  of  fever,  and  ought  never  to  be 
allowed.  I  have  seen  violent  relapses  into  bilious  and  intermittent  feveroccur 
in  consequence  of  the  patieat  having  eateu  a  piece  of  raw  apple. — HEMFEI,. 

5* 


106  FEVER. 

The  reviewer  of  the  first  edition  of  this  work  disap- 
proves of  water  which  has  not  been  drawn  fresh  from 
the  well ;  he  thinks  that  fresh  water  is  the  best  bever- 
age for  the  patient,  and  will  refresh  him  most,  pro- 
vided' it  is  given  by  the  spoonful.  Fever  patients 
sometimes  will  require  more  than  a  spoonful  of  a 
drink,  in  which  case  the  icy-cold  water  would  not  be  a 
suitable  drink.  The  water  which  the  patient  drinks 
in  the  winter-season  ought  to  have  been  standing  in  a 
warm  room  for  several  hours.  If  the  physician  were 
to  permit  his  patient  the  unlimited  use  of  icy-cold 
water,  and  the  patient  should  die,  this  sad  result  might 
be  attributed  to  the  use  of  that  liquid,  whereas  the 
use  of  moderately  cool  water  will  not  be  hurtful  to 
the  patient,  if  the  homoaopathic  remedy  have  been 
otherwise  well  selected.  The  use  of  icy-cold  water, 
which  is  insisted  upon  by  cholera  patients,  is  in  their 
case  an  exception  to  the  rule,  which  cannot  be  made  a 
law  for  all  fever  patients.  It  cannot  be  decided  be- 
forehand when  and  how  much  the  patient  is  to  drink  ; 
this  depends  upon  the  violence  of  the  fever  and  upon 
the  wants  and  desires  of  the  patient ;  it  would  evi- 
dently be  cruel  to  let  the  patient  suffer  thirst.  If  the 
patient  be  deprived  of  his  senses,  and  the  dryness  of 
the  lips  and  tongue  and  the  frequent  licking  indicate 
an  intense  thirst,  the  attendants  ought  frequently  to 
offer  the  patient  drink.  When  the  patient  is  thus 
panting  after  a  little  refreshment,  he  may  occasionally 
be  given  a  teaspoonful  of  a  mixture  of  orgeat  and  the 
juice  of  cherries,  mulberries,  or  sweet  oranges.  This 
compound  is  extremely  refreshing,  and  does  not  injure 
the  effects  of  the  medicine.  It  is  proper  never  to 
allow  the  patient  too  much  drink  at  once,  but  little  at 
a  time  and  frequently. 

The  best  drink  is  pure  spring  water.  This  is  the 
best  drink  to  quench  the  thirst.  If  the  patient  should 
get  tired  of  the  pure  water,  it  may  be  boiled  (which 
ought  especially  to  be  done  if  the  water  cannot  be  had 
pure),  after  which  it  is  to  be  cooled  again,  and  a  slice 
of  toasted  bread  or  rusk  to  be  soaked  in  it ;  or  the  water 
mav  be  boiled  together  with  the  toast,  and  afterwards 


FEVER.  107 

filtered  through  a  piece  of  linen.  This  liquid  may  be 
sweetened  with  sugar,  raspberry,  cherry,  althea,  mul- 
berry, or  apple-juice  ;  the  yolk  of  an  egg  may  be 
added,  or  a  refreshing  lemonade  may  be  prepared  out 
of  it  by  dropping  a  few  drops  of  the  juice  of  an  orange 
or  that  of  fresh  grapes  into  the  liquid.  Whether 
lemonade  made  of  lemon-juice  can  be  allowed  de- 
pends upon  circumstances,  and  has  to  be  left  to 
the  decision  of  the  physician.  Decoctions  of  dried 
apples,  cherries,  and  prunes,  are  likewise  pleasant  and 
allowable. 

The  next  drink,  after  water,  is  boiled  milk,  which 
cannot  be  used,  however,  in  all  kinds  of  erethic  fever, 
without  injuring  the  patient.  The  same  observation 
applies  to  buttermilk,  which,  although  generally 
pleasant  and  useful,  yet  has  to  be  used  with  great 
caution  in  gastric  and  pituitous  fevers.  The  patient 
may  likewise  use  the  so-called  white  German  ale.* 

Oatmeal  gruel,  rice,  and  barley-water,  and  other 
slimy  decoctions  of  a  similar  kind,  are  likewise  very 
agreeable ;  also  decoctions  of  both  fresh  and  dried 
fruit,  orgeat  made  of  sweet  almonds  ;  malt-drink,  pre- 
pared by  pouring  over  three  or  four  tablespoonfuls  of 
malt  a  quart  or  three  pints  of  boiling  water ;  and  va- 
rious other  decoctions. 

Moreover,  the  patient  may  use  broth,  a  light  warm 
beer  without  spices,  an  infusion  of  roast  and  ground 
cocao,  chocolate  without  spice,  and  an  infusion  of 
althea,  with  or  without  a  little  liquorice. 

§  20.  Mental  and  physical  quiet  is  an  important 
requisite  for  the  successful  treatment  of  fever.  The 
patient  has  to  be  on  his  guard  against  vehemence,  or 
against  emotions  of  any  kind,  on  whiuh  account  it  is 
advisable  that  no  one  but  the  necessary  attendants 
should  have  access  to  the  sick-chamber.  Hope  and 
confidence  are  the  only  emotions  which  exercise  a 
soothing  influence  on  fever  patients. 

§  21.  Quiet  sleep  being  very  desirable  to  the  fever 

*  This  is  beer  made  of  pure  malt,  which  has  fermented  in  the  open  air; 
it  is  a  mild  and  pure  beverage,  and  does  not  affect  the  brain.  The  patient 
may  use  it  diluted. — HEMPEL. 


108  SYNOCHAL  FEVER. 

patient,  all  unnecessary  attendance  in  the  sick-room 
ought  to  be  avoided,  nor  ought  the  frequent  closing 
and  opening  of  the  doors  to  be  tolerated.  The  patient 
ought  to  rest  upon  a  mattress,  and  be  covered  with  a 
light  quilt.* 

§  22.  Cleanliness  and  proper  clothing  deserve  great 
attention  in  fevers.  However  much  the  bulk  of  men 
may  be  prejudiced  against  washing  the  hands  and 
face  of  a  fever  patient  with  tepid  water,  this  is  no 
reason  why  the  homosopathic  physician  should  con- 
form to  that  prejudice.  After  being  washed  with 
tepid  water  the  patient  feels  invigorated  and  refreshed. 
If  the  exhalation  from  the  skin  be  very  considerable,  it 
is  even  necessary  that  the  whole  body  should  be 
washed  with  tepid  water  every  three  or  four  days, 
observing  the  precaution,  however,  to  dry  the  body 
immediately.  The  cure  is  promoted  by  a  frequent 
change  of  linen ;  if  the  patient  perspire  a  good  deal, 
his  linen  ought  to  be  changed  several  times  a-day, 
always  observing  the  usual  precaution.  The  patient 
ought  never  to  have  on  too  much  covering,  lest  an 
unnecessary  perspiration  should  be  induced.  In  order 
that  the  patient  may  not  be  obliged  to  have  his  breast 
constantly  covered  with  the  bed-cover,  and  may  be 
allowed  to  keep  his  arms  upon  the  cover,  he  ought  to 
wear  a  vest  over  his  night-shirt,  which  is  to  be  made 
of  cotton  in  summer,  and  of  wool  in  the  winter. 


SPECIAL  PATHOLOGY  OF  FEVERS. 

FIRST    CLASS. 

FEVERS   AFFECTING   PRINCIPALLY    THE    CIRCULATORY 
APPARATUS. 

§  23.  Synochal  or  simple  inflammatory  fever. 

A  better  knowledge  of  human  diseases  and  an  al- 
most boundless  experience  have  convinced  modern 
physicians  that  a  pure  synochal  fever  either  does  not 

*  The  Germans  are  in  the  habit  of  using  feather-beds  as  a  covering,  which 
ought  not  to  be  tolerated  in  the  sick-room,  except  when  the  patient  com- 
plains of  excessive  cold,  ia  which  case  a  very  light  feather-bed  may  be  used. 


SYKOCHAL  FEVER.  109 

exist,  or  at  any  rate  that  it  does  not  exist  long  without 
affecting  a  special  organ,  and  that  it  occurs  especially 
as  an  accompanying  symptom  of  inflammation.  Not 
being  an  idiopathic  disease,  it  is  not  subject  to  any  fixed 
therapeutic  rules.  We  have  long  meditated  on  the 
subject  whether  a  pure  synochal  fever  ought  to  be  men- 
tioned in  a  work  on  pathology.  In  treating  of  the 
special  diseases  we  found  ourselves  frequently  obliged 
to  repeat  certain  general  remarks,  and  we  therefore 
concluded  to  devote  a  few  pages  to  the  pathology  and 
treatment  of  that  class  of  fevers,  in  order  to  be  able  to 
refer  to  that  chapter  whenever  occasion  should  require. 
The  synochal  fever  occurs  not  only  as  an  accompany- 
ing symptom  of  inflammatory  diseases,  but  ato  in 
young,  vigorous,  plethoric  subjects,  after  wounds, 
burns,  etc.,  in  the  shape  of  a  febris  irritativa,  and  as 
such  requires  the  attention  of  the  physician.  The 
simple,  benign,  acute,  ephemeral  fever  requires  no 
medical  treatment,  except  when  the  fever  assumes  a 
different  form  in  consequence  of  the  reaction  of  the 
organism  having  been  interrupted  by  the  indiscreet 
conduct  of  the  patient.  Another  fever  arising  from 
an  irritation  of  the  organism,  is  the  fever  of  dentition, 
which  is  more  closely  related  to  a  synochal  fever 
than  is  any  other  kind  of  fever. 

According  to  SchoBnlein  the  synochal  fever  is  of  the 
species  of  phlogosis ;  he  places  it  under  the  head  of 
arteritis  and  phlebitis.  Our  opinion  is  that  Scho3n- 
lein's  view  is  confirmed  only  in  a  few  cases,  and  that 
the  synochal  fever  is  scarcely  ever  sufficiently  de- 
veloped to  deserve  the  appellation  of  either  arteritis 
or  phlebitis. 

All  the  symptoms  of  an  inflammatory  fever  show 
that  the  irritable  sphere  is  principally  affected,  the 
heart  and  the  blood  vessels  are  irritated,  their  power 
being  apparently  increased,  and  the  temperature  of 
the  body  being  considerably  elevated.  The  nervous 
system  and  the  digestion  are  less  affected,  hence  it  is 
that  the  sensations  of  the  patients  are  correct,  definite 
and  clear,  and  that  he  is  fully  conscious  of  his  com- 
plaints and  feels  his  sufferings  intensely.  When  the 


110  SYNOCHAL  FEVER. 

cerebral  irritation  is  considerable  from  the  very  com- 
mencement and  the  delirium  is  more  continuous,  there 
is  ground  for  apprehending  a  typhoid  fever. 

The  fever  commences  with  a  violent  chill,  followed 
by  continual  heat,  the  pulse  is  hard,  full,  accelerated, 
not  easily  compressible,  the  tongue  is  dry,  slightly 
coated,  and  the  skin  is  dry ;  the  dulness  and  heavi- 
ness of  the  head,  which  exist  in  the  commencement  of 
the  paroxysm,  soon  pass  into  an  aching  and  pulsating 
pain,  especially  in  the  forehead ;  the  face  becomes 
red,  hot,  the  eyes  shining,  and,  in  sensitive  subjects, 
the  erethism  increases  even  to  spasms  and  delirium. 
The  breathing  is  hurried,  anxious,  the  breath  hot  and 
dry  ^the  arteries  throb,  the  secretion  of  urine  is  di- 
minished and  the  urine  itself  is  red  and  fiery ;  the 
thirst  is  excessive.  The  restlessness  and  anxiety  in- 
crease, alternating  with  interrupted  slumber  and  stu- 
por. The  appetite  disappears,  but  the  heat  and  dry- 
ness  of  the  mouth  occasion  an  increasing  desire  for 
cold  water.  Perspiration  affords  relief,  but  the  skin 
is  generally  dry  and  hot.  The  symptoms  are  worse 
in  the  evening ;  their  violence  begins  to  abate  after 
midnight,  and  is  least  in  the  morning. 

A  general  inflammatory  fever  seldom  exists  with- 
out some  local  inflammation,  especially  "when  there  is 
a  congestion  of  blood  to  a  special  organ  in  the  com- 
mencement of  the  disease,  in  which  case  the  pulse  is 
contracted,  small,  but  hard.  These  fevers  are  fre- 
quently accompanied  by  bleedings,  especially  from  the 
nose,  which,  however,  afford  a  good  deal  of  relief. 

Synochal  fevers  seldom  last  long  unless  they  have 
become  complicated  by  the  supervention  of  some 
other  affection,  or  have  passed  into  a  different  form  of 
fever;  they  frequently  terminate  after  a  short  dura- 
tion by  a  critical  sweat,  and  a  turbid  urine  depositing 
a  sediment. 

§  24.  The  prognosis  of  an  inflammatory  fever  is  fa- 
vourable. Such  a  fever  is  never  fatal  of  itself.  It 
may  become  so,  however,  by  passing  into  another  dis- 
ease or  by  terminating  in  exhaustion,  which  is  the 
case  when  the  fever  becomes  complicated  with  in- 


SYNOCHAL  FEVER.  Ill 

flammation  of  a  noble  organ,  of  the  veins  or  arteries, 
or  when  a  typhoid  condition  supervenes.  In  giving  a 
prognosis  the  physician  has  to  consider  the  peculiar 
character  of  the  disease  in  the  case  of  his  patient, 
and  the  individuality  of  the  latter. 

Among  the  exciting  causes  we  may  notice  the  fol- 
lowing :  the  tendency  to  epidemic  diseases  and  the 
peculiar  character  \vhich  diseases  are  disposed  to  as- 
sume, more  particularly  in  spring  and  winter  when 
north-westerly  winds  prevail ;  the  excessive  use  of 
stimulating  and  heating  food,  producing  a  correspond- 
ing excess  of  animal  life  ;  suppression  of  the  activity 
of  the  skin  and  of  other  secretions,  echauffement,  vio- 
lent exercise,  abuse  of  spirituous  drinks,  contagia, 
wounds,  burns,  dry  and  cold  air,  not  to  forget  violent 
emotions,  such  as  fright,  fear,  chagrin,  anger  ;  or  the 
violent  irritation  which  children  suffer  during  the  pe- 
riod of  dentition. 

§  25.  In  treating  these  fevers  we  have,  in  the  first 
place,  to  consider  their  character  and  course.  At  the 
commencement  of  the  fever,  it  is  not  very  difficult  to 
select  a  remedy.  The  business  of  the  physician  is  to 
allay  the  fever  before  the  local  inflammation  has 
developed  itself.  There  is  no  better  remedy  to  allay 
the  fever  than  Aconite.  The  physician  is  scarcely 
ever  sent  for  during  the  chill,  as  it  is  supposed  that 
this  chill,  \vhich  sets  in  suddenly  and  without  any  pre- 
cursory symptoms,  is  a  merely  transitory  symptom  the 
end  of  which  ought  to  be  awaited  first  before  sending 
for  a  physician.  If  the  physician  were  sent  for  during 
the  chill,  it  would  not  be  advisable  that  he  should 
administer  a  remedy  before  the  second  stage  has  made 
its  appearance  ;  for  in  that  stage  it  is  much  easier  to 
select  a  remedy,  inasmuch  as  the  symptoms  of  the 
case  have  become  more  numerous  and  more  charac- 
teristic. In  general  it  is  not  advisable  to  exhibit  the 
homoeopathic  remedy  during  the  chill,  as  we  have 
abundant  evidence  of  the  fact  that,  by  so  doing,  the 
disease  is  considerably  increased. 

The  essential  sphere  for  the  action  of  Aconite  are 
the  erethic  fevers,  the  inflammatory  erethisms  of  the 


112  SYNOCHAL  FEVER. 

vascular  system,  and  the  first  stage  of  catarrhal, 
rheumatic,  and  traumatic  inflammations  ;  hence  that 
sphere  extends  from  the  simple  ephemeral  erethisms 
up  to  the  synocha,  and  from  the  simple  catarrhal 
and  rheumatic  fever  up  to  the  most  intense  phlogo- 
sis,  without  any  marked  local  affection.  Aconite 
is  a  true  universal  remedy,  our  most  charming  an- 
tiphlogistic, superior  to  venesection,  leeches,  "and 
cupping ;  it  cures  without  depletion,  and  in  a  much 
shorter  time  than  those  violent  means  which  weaken 
the  organism  and  reduce  its  vital  energy.  Any  one 
who  is  acquainted  with  the  physiological  effects  and 
the  true  character  of  Aconite,  must  certainly  know 
from  experience  that  Aconite  can  only  do  good  in  the 
sphere  of  action  which  we  have  assigned  to  it,  pro- 
vided the  dose  is  proportionate  to  the  susceptibility  of 
the  patient's  organism  and  the  intensity  of  the  disease. 
Aconite  is  a  specific  remedy  in  inflammatory  fevers 
with  congestion  to  the  chest  or  head,  the  pain  which 
the  patients  suffer,  appears  intolerable  to  them,  they 
are  exceedingly  nervous  and  restless  ;  this  is  especially 
the  case  with  young,  lively,  plethoric  subjects  leading 
a  sedentary  life.  Aconite  is  especially  useful  in  fevers 
which  are  occasioned  by  raw  north- westers  or  by  a 
current  of  air,  and  which  are  characterized  by  the 

Mowing  symptoms  :  great  general  heat,  especially 
>ut  the  head  and  face  ;  vivid  redness  of  the  cheeks, 
great  thirst,  stinging,  beating  headache  and  excessive 
painfulness  of  the  \vhole  head,  vertigo  and  nightly 
delirium,  restlessness,  moaning,  anxiety,  tossing  about 
in  consequence  of  the  limbs  feeling  bruised  and  para- 
lyzed ;  alternation  of  chilliness  and  dry,  burning  heat, 
with  shortness  of  breath  and  dry,  hacking  cough  ;  in- 
tolerance of  noise,  ill  humour,  despondency  even  unto 
weeping ;  glistening  eyes,  roaring  in  the  ears,  great 
irritation  of  all  the  senses  ;  dryness  of  the  lips,  mouth 
and  tongue  ;  hasty  and  tremulous  speech,  burning  un- 
quenchable thirst,  bitter  taste  with  empty  eructations 
and  with  a  qualmish  feeling  in  the  pit  of  the  stomach  ; 
scanty  secretion  of  a  highly-coloured,  hot  urine. 
The  dose  should  be  adapted  to  the  age  and  constitu- 


BYNOCHAL  FEVEB.  113 

tion  of  the  patient.  In  the  commencement  of  the  dis- 
ease, and  in  young  and  delicate  patients,  the  higher 
attenuations  are  sufficient ;  full-grown,  vigorous 
patients,  and  the  later  periods  of  the  fever,  require 
stronger  doses,  sometimes  even  a  drop  of  a  lowef  at- 
tenuation. This  kind  of  fever  generally  resolves  it- 
self into  a  sweat,  which  is  extremely  salutary  and 
beneficient  in  those  affections,  and  is  so  much  more 
decisive  as  its  appearance  has  been  speedily  induced 
by  the  homoeopathic  agent.  It  is  highly  improper  to 
elicit  the  sweat  by  artificial  heat,  whether  externally 
or  internally  applied.  The  best  means  to  cause  the 
sweat  to  break  out  is  a  suitable  dose  of  Aconite,  which 
may  be  repeated  at  proper  intervals  and  whose  action 
may  be  assisted  by  giving  the  patient  as  much  cold 
water  as  he  desires.  If  the  sweat  breaks  out,  and  the 
urine  becomes  more  watery,  the  fever  is  broken  and  no 
farther  medication  is  required. 

If  the  synochal  fever  be  merely  an  accompanying 
symptom  of  a  local  affection,  our  first  duty  is  to  mode- 
rate the  fever,  unless  we  know  a  remedy  which  covers 
both  the  fever  and  the  local  affection.  Even  in  most 
of  these  cases,  Aconite  is  the  principal  remedy,  corre- 
sponding both  to  internal  inflammations  and  to  in- 
flammatory cutaneous  diseases.  We  refer  the  reader 
to  the  second  division  of  the  first  volume,  where  both 
classes  of  diseases  are  treated  in  detaiL 

There  are  several  other  remedies,  besides  Aconite, 
which  may  be  used  for  the  cure  of  synochal  fever,  but 
they  are  much  less  important  than  Aconite,  and  can 
only  be  employed  when  the  fever  assumes  a  particular 
form  from  the  commencement,  when  it  is  not  very  vio- 
lent, when  the  orgasm  is  confined  to  certain  regions, 
and  when  secondary  symptoms  occur.  The  principal 
remedies,  next  to  Aconite,  are  :  Bell.,  Bryon.,  Mercur., 
Canthar.,  Cham.,  Arnica  ;  other  remedies  which  have 
been  placed  in  the  same  category  with  the  preceding, 
do  not  properly  belong  here,  as  they  are  given  in  dis- 
eases where  the  fever  is  merely  a  sympathetic  affec- 
tion. 

Belladonna  is  th  s  principal  remedy,  and  ought  to  be 


114  SYNOCHAL   FEVER. 

given  after  Aconite,  in  cases  where  the  cerebral  sys- 
tem is  principally  affected,  and  the  following  symptoms 
occur :  burning  heat,  especially  of  the  head  and  face, 
the  latter  being  red  and  puffed;  strong,  quick,  full 
pulse,  violent  burning  thirst,  intense  delirium,  espe- 
cially at  night,  vertigo  and  aching  in  the  forehead  as 
if  it  would  burst ;  red,  shining  eyes,  anxiety  and  rest- 
lessness, and  tendency  to  start. 

Bryonia  is  indicated  when  the  orgasm  of  the  blood 
is  principally  confined  to  the  organs  of  the  chest,  ac- 
companied with  great  erethism  of  the  vascular  and 
nervous  system ;  burning,  dry  heat  mingled  with  chills, 
violent  thirst,  headache  as  if  the  whole  contents  of  the 
head  would  issue  through  the  forehead,  anxious  sleep, 
disturbed  with  moans,  short  cough  and  oppression  of 
the  chest.  In  a  synochal  -fever  of  that  sort  gastric 
symptoms  frequently  supervene  and  change  the  syno- 
cha  to  a  synochus  ;  for  many  complications  of  that 
kind  Bryonia  is  likewise  the  specific. 

Mercurius  acts  similarly  to  Bryonia,  with  this  dif- 
ference, that  it  is  not  so  much  indicated  by  local  symp- 
toms as  Kryonia,  and  it  is  principally  required  in  in- 
flammatory fevers  characterized  by  erethism  of  the 
nervous  sVstem,  a  disposition  to  profuse  sweat,  an 
accelerated,  irregular  pulse,  and  excessive  thirst  with 
desire  for  icy-cold  water.  These  symptoms  are 
accompanied  by  dulness  of  head,  and  a  pressure  in  the 
parietal  regions  from  within  outwards,  undulations  and 
beatings  in  the  sinciput.  The  supervening  gastric- 
bilious  symptoms  likewise  indicate  a  complication  or 
rather  the  transition  of  the  pure  synochal  into  a  gastric 
fever,  for  which  Mercurius  is  likewise  a  specific. 

Cantharides  are  indicated  in  violent  burning  fever, 
especially  at  night,  with  accelerated,  strong  pulse, 
general  redness  of  the  skin,  violent  thirst  and  dryness 
of  the  mouth,  accompanied  by  painful  sensations  in  the 
right  side  of  the  body,  great  anxiety,  delirious  talk  about 
business,  etc.*  4+ 

Neither  Cantharides  nor  Chamomilla  can  be  said  to 

*  Especially  when  there  is  a  frequent  desire  to  urinate. — HEMPEL. 


FEVER  OF  DENTITION.  115 

be  indicated  in  pure  inflammatory  fevers  ;  the  fevers 
for  which  those  remedies  are  indicated  consist  rather 
of  attacks  of  heat  having  the  character  of  a  synochal 
fever ;  the  fevers  indicating  Chamomilla  are  charac- 
terized by  heat  mingled  with  occasional  chills,  by 
bright  redness  of  the  cheeks,  tremulous  and  anxious 
palpitation  of  the  heart,  great  irritability  of  temper  and 
excessive  sensibility  of  all  the  senses,  etc.  Chamo- 
milla corresponds  especially  to  those  fevers  which  have 
been  occasioned  by  anger  and  chagrin  (giving  first, 
however,  a  few  doses  of  Aconite),  and  are  generally 
accompanied  by  spasmodic  symptoms. 

Arnica  corresponds  only  to  such  inflammatory  fevers 
as  have  been  occasioned  by  contusions,  tearing  of 
muscles,  and  wounds  of  any  kind  ;  the  violence  of 
the  orgasm  requires  in  the  first  place  to  be  moderated 
by  Aconite.  If  the  injuries  are  very  considerable, 
dilute  tincture  of  Arnica  maybe  used  externally,  in  the 
shape  of  a  wash  or  a  poultice. 

§  26.  Fever  of  dentition. 

The  cutting  of  teeth  is  no  disease  of  itself,  but  a 
natural  occurrence  in  the  period  of  evolution.  It  is  a 
stage  in  the  physical  development  which  marks  at  the 
same  time  the  commencement  of  the  intellectual  life 
of  the  child.  At  that  period  the  child  begins  to  utter 
articulated  sounds  and  to  exhibit  signs  of  rationality.* 
Life,  in  this  period,  is  liable  to  the  same  dangers  as  in 
the  other  periods  of  development.  If  the  irritation 
produced  by  the  cutting  of  teeth  be  very  violent,  which 
will  generally  be  the  case  when  several  teeth  are  cut 
together,  a  febrile  condition  is  induced  resembling  so 
closely  a  synochal  fever  that  we  deem  it  expedient  to 
speak  of  it  as  belonging  to  that  class  of  diseases.  In 
order  not  to  scatter  the  various  ailments  occurring 
during  the  period  of  dentition,  through  separate  parts 
of  this  work,  we  shall  describe  them  all  in  this  chapter. 

*  The  great  French  philosopher,  Charles  Fourier,  author  of  the  Doctrine 
of  the  Universal  Association  of  Capital,  Labour  and  Talent,  says,  in  his  great 
work  on  that  subject,  that  the  period  of  dentition  is  the  time  when  the  soul 
truly  conjoins  itself  to  the  body ;  previous  to  that  time  the  organism  merely 
vegetates  and  exists  from  the  same  geueral  vital  principle  that  sustains  the 
life  of  the  planet. 


116  FEVER  OP  DENTITION. 

Not  all  the  morbid  phenomena  occurring  during  the 
period  of  dentition,  are  directly  occasioned  by  the  rup- 
ture of  the  gums  ;  these  phenomena  as  well  as  the 
teething  itself  are  developments  \vhich  belong  to  one 
another,  and  are  characteristic  signs  of  a  new  period 
of  life  upon  which  the  child  has  entered ;  the  child's 
individuality  becomes  more  marked  and  the  child  is 
less  dependant  on  the  mother.  Upon  reviewing  the 
whole  life  of  man  we  will  find  that  every  new  period  of 
life  is  characterized  by  striking  bodily  phenomena,  in 
which  not  only  the  nervous  system  but  also  the  mind 
is  interested  more  or  less,  in  such  a  manner,  however, 
that  neither  the  physical  nor  the  mental  phenomena 
can  be  said  to  be  either  essential  or  accidental,  prima- 
ry or  secondary. 

The  same  remark  applies  to  the  cutting  of  teeth 
and  to  the  phenomena  accompanying  that  process. 
These  phenomena  are  at  times  of  a  nervous,  at  times 
of  a  febrile  nature,  sometimes  they  are  mixed.  But 
whether  nervous  or  febrile,  they,  as  well  as  all  other 
infantile  diseases,  are  easily  recognised  by  the  parents 
or  the'  physician,  and  the  symptoms  are  generally  so 
well  marked  that  it  is  much  easier  to  select  a  specific 
remedy  for  the  diseases  of  children  than  for  those  of 
full-grown  persons,  which  may  partly  be  owing  to  the 
children's  mode  of  life  being  much  more  simple  than 
that  of  full-grown  persons. 

The  phenomena  of  teething  occur  in  the  period 
from  the  fifth  to  the  fifteenth  or  sixteenth  month. 
The  border  of  the  jaw  which  requires  to  be  pierced, 
gradually  enlarges  and  becomes  indented  as  it  were, 
the  child's  mouth  fills  with  water,  the  hand  is  frequent- 
ly and  quickly  carried  into  the  mouth,  or  hard  sub- 
stances are  pushed  into  it  to  bite  them,  the  mouth  is 
hot,  the  child  does  not  like  the  inner  mouth  to  be 
touched,  utters  frequent  and  sudden  cries  as  if  in  dis- 
tress ;  the  gums  are  swollen,  whitish,  especially  so 
along  the  edges,  afe  if  a  tooth  were  shining  through, 
they  become  hot  \nd  painful.  These  symptoms  are 
most  frequently  accompanied  by  diarrhosa,  which,  how- 
ever, is  a  natural  derivative  means,  and  the  best  pre- 


FEVER  OF  DENTITION.  117 

ventive  against  fever,  cerebral  affections,  spasms ;  in 
some  cases  constipation  occurs  instead  of  diarrhoea  ; 
fever,  cutaneous  eruptions,  heat  of  the  head,  cough, 
rattling,  difficult  respiration,  spasms,  convulsions,  in- 
flammation of  the  brain  or  lungs,  may  likewise  occur. 

In  order  to  be  able  to  judge  correctly  whether  the 
phenomena  accompanying  dentition  constitute  an  es- 
sential portion  of  that  process  in  the  case  which  we 
are  called  upon  to  treat,  the  physician  ought  to  pos- 
sess a  correct  knowledge  of  the  course  and  the  cha- 
racter of  the  teething  process.  It  is  of  course  to  be 
presumed  that  every  physician  possesses  that  know- 
ledge ;  ho"wever,  in  order  to  be  complete,  we  will  give 
a  short  description  of  the  phenomena  of  teething  in 
the  subjoined  paragraph. 

The  teeth  begin  to  be  formed  a  few  months  before 
the  child  is  born.  The  tooth  forms  by  a  process  of 
crystallization  out  of  a  jelly-like  substance  contained 
in  membranous  sacs  in  the  jaws.  The  formation  of 
the  teeth  generally  commences  in  the  fifth  month. 
This  is  the  internal  development  of  the  tooth  which 
is  not  perceptible  to  the  senses,  its  internal  growth, 
extension  in  every  direction  and  consequent  nervous 
irritation.  First  appears  the  middle  pair  of  the  inci- 
sors ;  the  outer  pair  appears  later  ;  the  first  molar 
teeth  are  cut  towards  the  end  of  the  first  year ;  the 
cuspidati  at  the  end  of  the  second  year,  and  lastly  the 
second  molar  teeth.  The  more  regular,  successive 
and  retarded  the  cutting  of  the  teeth,  the  less  are  the 
sufferings  of  the  patient.  The  corresponding  teeth  on 
both  sides  are  not  cut  at  the  same  time,  generally  the 
lower  teeth  are  cut  first. — The  symptoms  abate  and 
then  recur  again  at  intervals,  they  cease  entirely  as 
soon  as  the  tooth  is  cut,  increase  in  violence  if  the 
cutting  do  not  take  place,  and  frequently  become  fatal, 
convulsions,  apoplexy  and  suffocation  supervening. 

§  27.  The  ailments  occasioned  by  a  natural  denti- 
tion do  not  require  any  medicine  ;  parents  who  are 
disposed  to  be  very  anxious,  might  perhaps  be  desi- 
rous of  having  some  medicine  given  to  their  children. 
The  erethism  which  generally  accompanies  dentition 


118  FEVER  OF  DENTITION. 

is  most  easily  subdued  by  a  few  doses  of  Coffea  cruda. 
This  remedy  may  however  remain  without  any  effect 
if  the  mother  or  the  child  should  have  been  in  the 
habit  of  using  coffee  as  their  daily  beverage.  In  such 
a  case  Aconite  and  afterwards  Chamomilla  would  de- 
serve the  preference.  A  flow  of  saliva,  loose  stool  or 
diarrhosa,  which  generally  accompany  the  cutting  of 
teeth,  do  not  require  any  treatment ;  those  symptoms 
disappear  as  soon  as  the  cutting  is  accomplished. 

Children  in  whom  the  irritation  consequent  upon 
dentition,  continues  for  a  long  time,  and  who  lose 
strength  or  flesh  in  consequence  of  it,  are  relieved  by 
a  few  doses  of  Calc.  carb.,  which  ought  to  be  given  at 
tolerably  long  intervals ;  this  remedy  is  generally  suf- 
ficient to  remove  all  the  troublesome  symptoms  ac- 
companying teething  without  any  other  remedy  being 
required  afterwards. 

Teething  is  sometimes  accompanied  with  a  febrile 
condition,  appearing  and  disappearing  at  intervals, 
and  constituting  a  sort  of  synochal  fever,  the  paroxysms 
of  which  recur  every  day.  This  is  the  real  fever  of 
dentition,  and  deserves  especial  consideration  when  it 
occurs  in  plethoric,  fleshy  children,  in  whom  it  in- 
clines to  become  a  local  affection.  This  fever  is 
treated  as  every  other  affection,  except  that  the  suc- 
cessful treatment  of  that  fever  requires  the  utmost  re- 
gard to  the  irritability  etc.  of  the  patient,  which  is 
uncommonly  increased  at  that  period  of  life.  All  the 
diseases  which  occur  during  the  period  of  dentition,  as 
well  as  the  morbid  phenomena  accompanying  dentition, 
require  the  utmost  care  on  the  part  of  the  practitioner. 
All  that  the  physician  can  do  is  to  subdue  the  irrita- 
tion of  the  various  systems,  and  the  disease  is  thus 
frequently  cut  short  in  the  most  striking  manner. 

Aconite  is  the  best  remedy,  by  means  of  which  that 
irritation  is  accomplished.  In  general,  this  remedy  is 
of  great  importance  in  the  diseases  of  infancy,  where 
the  least  vascular  erethism  is  easily  increased  to  a 
synochal  fever,  on  account  of  the  greater  activity  pre- 
vailing in  the  vascular  system  previous  to  the  develop- 
ment of  the  organs  being  accomplished.  No  remedy 


FEVER  OF  DENTITION.  119 

is  better  adapted  than  Aconite  to  allay  that  fever ;  in 
cases  where  the  febrile  orgasm  had  been  prepared  and 
increased  by  the  daily  use  of  coffee  on  the  part  of  the 
mother  and  the  child,  Aconite  is  indispensable  prior  to 
any  other  remedy. 

The  slighter  degrees  of  increased  irritability  in  the 
vascular  or  nervous  system,  indicated  by  an  increase 
of  temperature  ;  thirst,  sudden  screams  and  grasping 
at  the  mouth,  startings  during  sleep  as  if  in  affright, 
etc.,  are  sometimes  relieved  with  Coffea  or  Aconite, 
Chamomilla  or  Nux ;  Coffea  and  Chamomilla  are 
especially  indicated  when  the  symptoms  of  a  morbidly 
irritated  sensibility  prevail ;  Aconite  is  preferable 
when  the  principal  irritation  exists  in  the  vascular 
system ;  Nux  is  the  best  remedy  when  those  symptoms 
are  accompanied  with  a  short  and  dry  cough  and  cos- 
tiveness.  If  the  excessive  irritability  and  sensibility 
of  the  nervous  system  is  accompanied  with  great  sen- 
sitiveness to  the  pain  occasioned  by  the  breaking  of 
the  gums,  with  thirst,  heat,  and  redness  of  one  cheek, 
and  sweat  about  the  head,  especially  with  a  catarrhal 
cough,  hoarseness  and  rattling  of  mucus  in  the 
trachea,  in  that  case  no  remedy  surpasses  Chamomilla. 
Chamomilla  is  likewise  the  best  remedy  when  the 
child  has  been  brought  up  without  the  breast,  and  the 
fever  is  continuous,  and  accompanied  with  great  agi- 
tation of  the  nervous  system,  as  manifested  by  anxiety 
and  restlessness,  starting  on  hearing  anything  fall,  or 
upon  hearing  the  least  npise,  starting  without  after- 
wards being  able  to  compose  one's-self,  convulsive 
twitchings  of  the  limbs  while  falling  asleep. 

If  Chamomilla  should  not  be  sufficient,  if  the  patient 
be  plethoric  and  fleshy,  if  the  symptoms  be  worse  in 
the  afternoon  or  at  night ;  if,  for  instance,  convulsions 
or  spasms  be  renewed  by  the  least  contact ;  if  the 
child's  limbs  or  head  be  very  restless  and  in  constant 
emotion  ;  if  the  sleep  be  interrupted  by  screams,  moans, 
convulsions  or  jerks  through  the  whole  body  resem- 
bling electric  shocks  ;  if  the  patient  suffer  violent, 
burning  heat,  great  thirst ;  if  the  skin  be  red,  the  limbs 
tremble ;  if  there  be  anxiety,  a  short,  quick,  noisy 


120  FEVER  OF  DENTITION. 

respiration,  visible  oppression  of  the  chest,  red  eyes ; 
in  this  case  no  remedy  is  better  adapted  to  the  symp- 
toms than  Belladonna. 

§  28.  Although  we  shall  afterwards  treat  in  detail 
of  spasms  and  convulsions,  yet  we  will  here  make 
cursory  mention  of  the  epileptic  fits  which  some- 
times occur  during  dentition.  To  the  convulsions  oc- 
casioned by  teething  we  have  already  alluded  in  the 
former  paragraph.  In  many  cases  we  observe,  at 
first,  the  same  symptoms  as  have  been  indicated  in  the 
preceding  paragraph ;  in  other  cases  the  precursory 
symptoms  are  diarrhoeic  stools  for  several  days  ;  in 
others,  again,  the  fits  are  preceded  for  a  few  days  by 
groat  paleness  of  countenance,  faint  eyes  almost  with- 
out any  lustre,  little  appetite  ;  the  child  rests  its  head 
upon  the  shoulder  of  the  nurse,  and  wants  to  lie  down 
all  the  time.  As  long  as  these  indefinite  symptoms 
prevail,  Chamomilla  is  the  best  remedy,  by  which  more 
serious  accidents  are  sometimes  averted.  If  these 
precursory  symptoms  be  left  unheeded,  the  epileptic 
fit  frequently  sets  in  with  great  force  :  for  a  few 
minutes  the  child  lies  in  a  state  of  rigor,  rolls  its  eyes, 
distorts  the  features,  is  attacked  with  convulsions,  toss- 
ing of  the  limbs,  clenching  of  the  thumbs,  the  whole 
body  bending  backwards  and  sideways ;  the  breathing 
becomes  wheezing  and  rattling,  with  foam  at  the 
mouth,  and  vivid  redness  and  puffiness  of  the  counte- 
nance; in  short,  all  the  symptoms  of  an  epileptic  fit 
set  in,  lasting  from  a  few  minutes  to  half  an  hour,  after 
which  the  child,  evidently  suffering  with  congestion  of 
the  brain,  falls  into  a  sopor,  at  the  termination  of 
which  the  convulsions  either  return  immediately  or 
after  a  short  interval.  Although  no  fever  may  be 
present  \vhen  the  fits  first  commence,  yet  it  appears 
shortly  after,  as  a  secondary  affection,  in  the  shape  of 
an  inflammatory  typhus ;  this,  however,  is  not  to  be 
regarded  as  the  principal  affection,  although  a  remedy 
ought  not  to  be  chosen  without  due  regard  to  the 
febrile  symptoms. 

Belladonna  is  probably  the  best  specific  against  an 
attack  as  described  above,  especially  when  the  chil- 


FEVER  OF  DENTITION,  121 

dren  start  from  their  sleep  as  in  affright,  cast  anxious 
looks  around  them,  or  stare  at  an  object  with  wild 
eyes  and  dilated  pupils,  all  the  muscles  of  the  body 
being  spasmodically  stretched,  the  whole  body  being 
in  a  state  of  rigor,  the  forehead  and  hands  burning 
hot,  and,  in  some  cases,  involuntary  discharges  of  urine 
taking  place. 

An  excellent  remedy  in  that  disease  is  Ignatia  amara, 
which  has  been  used  with  great  success  by  most 
homoeopathic  physicians.  The  fits  which  correspond 
to  Ignatia  are  generally  preceded  by  precursory  symp- 
toms which  are  not  as  clearly  marked,  it  is  true,  as 
those  indicating  Belladonna,  but  are  sufficiently  char- 
acteristic to  point  to  Ignatia.  The  moral  symptoms 
are  especially  characteristic :  the  children  are  head- 
strong and  irritable,  are  not  satisfied  with  anything ; 
they  are  peevish  and  out  of  humour,  and  cry  when  the 
least  thing  they  ask  for  is  refused ;  those  symptoms 
are  sometimes  accompanied  with  sudden  flushes  of  heat 
over  the  whole  body,  red  cheeks,  burning  ears,  absence 
of  thirst ;  besides  all  this,  the  children  are  very  un- 
manageable. These  premonitory  symptoms  sometimes 
exist  for  many  days,  until  the  fit  sets  in  suddenly  with 
suffocative  anguish,  foaming  at  the  mouth,  rigor  of  the 
neck,  reclining  of  the  head,  redness  of  the  face,  dis- 
tortion of  the  eyes,  loss  of  consciousness.  Sometimes 
such  a  fit  sets  in  without  any  premonitory  symptoms, 
and  without  any  apparent  cause,  except  that  the  chil- 
dren had  been  naughty,  and,  after  having  been  punish- 
ed, \vere  laid  to  bed ;  this  is  generally  a  bad  practice. 

Next  to  Ignatia,  Ipecacuanha  is  the  best  remedy. 
Ipecacuanha  is  preferable  to  Ignatia  when  the  fit 
arises  from  overloading  the  stomach  with  pastry.  The 
precursory  symptoms  of  the  Ipecacuanha  fit,  accom- 
panied with  symptoms  of  teething,  generally  resemble 
those  of  dyspepsia  and  the  ailments  arising  from  it ;  per- 
manent characteristics  of  that  condition  are  :  paleness 
of  countenance  and  cool  skin,  violent  cries,  and  grasp- 
ing at  the  mouth.  The  true  Ipecacuanha  fit  is  dis- 
tinguished from  the  Ignatia  fit  by  the  following  symp- 
6 


122  FEVER  OF  DENTITION. 

toms  :  extension  and  rigor  of  the  whole  body,  occa- 
sionally interrupted  by  spasmodic  jerks  through  the 
arms ;  constant  spasmodic  motion  of  the  facial  muscles, 
in  which  the  lips  and  eyelids  are  involved. 

We  have  to  mention  one  other  remedy  which  is 
frequently  indicated  against  epilepsy,  especially  when 
the  fit  was  occasioned  by  fright,  and  consecutive  fear. 
The  Opium  fits — for  that  is  the  remedy — commence 
with  a  convulsive,  spasmodic  trembling  of  the  limbs, 
which  is  interrupted  only  by  jerks  of  the  body  and 
twitchings  of  the  limbs,  accompanied  with  a  croaking 
scream,  and  giving  way,  after  a  while,  to  a  soporous 
state,  during  which  the  child  snores  with  an  open 
mouth,  and  from  which  the  patient  cannot  be  roused. 
The  Opium  fits  only  appear  at  night ;  this  is  character- 
istic. 

Besides  the  above-mentioned  remedies,  the  following 
remedies  may  be  used  for  epilepsy,  which  will  be 
described  in  detail  when  we  come  to  treat  of  that  dis- 
ease :  Cina,  Rhus,  Arsenic,  Cuprum,  Calc.  carb., 
Causticum,  Arnica,  Hyosciam.,  Stram.,  Cicuta,  Secale 
c.,  Stannum,  Zincum,  and  others. 

There  is  another  kind  of  epilepsy  to  which  those 
children  are  liable  who  are  nursed  by  females  addict- 
ed to  the  use  of  spirituous  drinks.  That  kind  of 
epilepsy  likewise  occurs  during  the  period  of  dentition. 
It  yields  to  a  few  doses  of  Nux,  provided  the  nurse 
abstains  from  the  use  of  spirits,  or,  if  this  should  be 
impossible  to  her,  weans  the  child.  That  kind  of 
epilepsy  is  perhaps  more  dangerous  than  any  other, 
because  the  organism  of  the  child  is  entirely  ruined  by 
the  vicious  habits  of  the  nurse.  Nevertheless,  the 
physician  is  bound  to  attempt  a  cure,  and,  if  Nux 
should  be  of  no  avail,  he  may  try  Arsenic.  It  would 
seem  as  if  a  delicate  creature  like  woman  could  not 
be  guilty  of  such  conduct,  were  she  even  born  in  the 
meanest  hovel.  We  thought  so  until  we  were  con- 
vinced of  the  contrary  by  actual  facts.  Not  malice, 
however,  and  rarely  habit  or  the  love  of  vice,  induces 
the  misconduct  which  we  here  censure  ;  the  liquor  is 


CATARRHAL  FEVER.  123 

generally  drank  for  the  purpose  of  procuring  the  child 
rest  and  sleep  ;  it  is  the  success  in  accomplishing  this 
which  leads  to  the  vicious  habit. 

Children  who  are  brought  up  without  the  breast  are 
liable  to  another  kind  of  epileptic  fit.  This  is  generally 
induced  by  overloading  and  deranging  the  stomach. 
If  the  precursory  symptoms  are :  inclination  to  vomit, 
retching,  the  vomiting  ought  to  be  brought  on  by 
tickling  the  velum  pendulum  palati  and  the  fauces, 
after  which  the  patient  ought  to  be  given  a  few  tea- 
spoonfuls  of  black  coffee,  followed  by  Ipec.,  Puls., 
Bryon.,  Nux,  or  any  other  suitable  remedy. 


SECOND   CLASS. 
FEVERS,    AFFECTING     PRINCIPALLY    THE     MUCOUS    MEMBRANES. 

§  29.   Catarrhal  fever. 

An  intense  irritation  of  a  greater  or  lesser  portion 
of  the  mucous  membranes  induces  a  febrile  state. 
The  symptoms  of  that  febrile  condition  are  those  of  a 
catarrhal  fever  \vhich  may  be  principally  seated  in 
the  mucous  membranes  of  the  respiratory  and  repro- 
ductive, or  else  in  the  genital  and  uropoetic  system. 
Generally  speaking,  we  understand  by  catarrhal  fever 
an  affection  of  the  respiratory  organs.  It  is  a  sort  of 
sjnnochus  of  the  lighter  kind,  continuous  and  remitting, 
and  commencing  towards  evening  with  a  slight  chill, 
rather  resembling  a  creeping  over  the  bones,  accom- 
panied by  a  soft  pulse  which  is  not  very  much  accele- 
rated, thirst,  restlessness,  and  sometimes  great  lassi- 
tude. In  company  with  this  fever  the  mucous  mem- 
brane of  the  throat,  chest,  nasal,  maxillary  and  frontal 
cavities  appears  more  or  less  inflamed.  At  first  the 
mucous  membrane  thus  irritated  does  not  secrete  any- 
fluid,  or  only  a  watery,  acrid  humour,  which  is  after- 
wards transformed  into  a  viscid,  thick,  slimy  sub- 
stance ;  the  tongue,  at  the  same  time,  exhibits  a  white 
coating,  the  smell  is  gone,  the  taste  altered,  the  diges- 
tion is  disturbed,  the  urine  is  red,  turbid,  generally  de- 
positing a  profuse,  slimy  sediment,  and  a  dull  aching 


124  CATARRHAL  FEVER. 

pain  is  experienced  in  the  head,  especially  in  the  fron- 
tal cavities. 

The  irritation  sometimes  extends  over  the  mucous 
membranes  of  neighbouring  organs,  or  even  of  the 
whole  organism,  occasioning  a  variety  of  unpleasant 
and  painful  sensations,  and  increasing  the  intensity  of 
the  fever.  The  conjunctiva  is  red  and  turgid,  the  eye 
is  either  dry  or  secretes  an  abundance  of  tears,  and  is 
very  sensitive  to  the  light.  The  affection  of  the  mu- 
cous membrane  lining  the  nasal  cavities  is  charac- 
terized by  creeping  and  frequent  sneezing,  and  by  an 
aching  pain  over  the  eyes  (coryza).  Sometimes  the 
affection  extends  to  the  larynx  and  trachea,  causing 
an  alteration  of  the  voice,  roughness  and  hoarseness ; 
the  affection  of  the  tracheal  mucous  membrane  shows 
itself  by  the  oppressive  breathing  and  the  dry  cough. 

§  30.  A  catarrhal  fever  may  be  caused  by  a  sudden 
suppression  of  the  perspiration  by  a  current  of  air,  by 
a  sudden  change  of  temperature,  or  by  a  dry,  sharp 
and  cold  air.  Most  of  those  fevers  which  depend 
upon  a  contagious  miasm,  generally  commence  with 
a  catarrhal  fever ;  catarrhal  fevers  may  be  occasioned 
by  contagia,  and  occur  principally  at  times  when  the 
measles  and  whooping-cough  are  prevalent  among 
children  ;  they  may  likewise  occur  in  consequence  of 
the  respiratory  organs  having  been  irritated  by  violent 
inspirations  during  physical  exertions,  such  as  dancing, 
screaming,  singing,  running  ;  and  lastly,  they  may  be 
caused  by  the  inhalation  of  acrid  vapours,  especially 
in  individuals  who  are  very  sensitive  to  external  at- 
mospheric influences,  and  had  been  frequently  affected 
with  catarrh  before. 

§  31.  In  simple  catarrhal  fevers  the  prognosis  is  fa- 
vourable. They  are  frequently  cured  spontaneously 
by  an  increase  of  perspiration  and  the  discharge  of  a 
turbid,  clayish-looking  urine ;  the  local  affection,  how- 
ever, lasts  somewhat  longer  and  disappears  only 
gradually  through  the  secretion  of  a  profuse,  thick, 
yellow,  inoffensive  mucus.  The  secretion  of  that 
mucus  is  to  be  considered  a  favourable  crisis.  A  ca- 
tarrhal fever  is  least  dangerous  when  the  inflamma- 


CATARRHAL  FEVER.  125 

tion  affects  the  nasal  mucous  membrane  only;  the 
prognosis  is  more  doubtful  when  the  mucous  mem- 
brane of  the  lungs  0and  larynx  is  involved ;  in  that 
case  there  is  danger  of  the  local  affection  increasing 
to  an  inflammation  of  those  organs,  or  of  disorganiza- 
tions being  induced  -by  careless  treatment.  A  violent 
catarrhal  fever  is  to  be  treated  as  a  pure  synochal 
fever ;  the  local  irritation  increases  of  course  in  pro- 
portion to  the  intensity  of  the  fever.  A  catarrhal  sy- 
nocha  is  a  continuous  fever,  characterized  by  great 
heat,  restlessness,  thirst,  and  a  full,  tight,  hard  pulse, 
without  any  mucous  discharge. 

§  32.  Slight  catarrhal  fevers  get  well  of  themselves 
in  a  few  days  with  good  care,  leaving  at  most  only  a 
mild  fluent  coryza.  None  but  very  sensitive  patients 
send  for  a  physician  in  such  cases.  Some  cases  of  ca- 
tarrhal fever  are  so  mild  that  individuals  of  a  robust 
constitution  are  not  even  obliged  to  be  confined  to 
their  rooms,  but  are  able  to  attend  to  their  business  as 
usual.  Such  patients  have  been  known  to  get  well 
by  taking  a  glass  of  grog  or  punch  in  the  evening ; 
this  would  excite  perspiration  in  the  night,  which  was 
kept  up  next  morning  by  remaining  in  bed  a  little 
longer  than  usual,  and  was  found  sufficient  to  restore 
the  equilibrium  of  the  functions.  A  glass  of  grog  is 
no  homoeopathic  remedy,  of  course  ;  we  allude  to  it 
merely  as  a  palliative  means  which  has  been  success- 
fully used  in  a  great  many  cases  of  mild  catarrhal 
fever. 

The  danger  increases  if  the  local  irritation  and  con- 
sequently the  fever  be  more  intense  and  the  mucous 
discharge  more  difficult.  In  such  cases  the  local  irri- 
tation requires  our  principal  attention  in  selecting  a 
remedy  ;  whereas  the  febrile  symptoms  are  the  most 
important  if  the  local  irritation  have  an  inflammatory 
character.  The  homoeopathic  physician  should  be  on 
his  guard  in  this,  as  in  every  case,  against  being 
carried  away  by  one  or  two  symptoms  instead  of  care- 
fully observing  the  whole  group.  This  kind  of  routine 
or  symptomatical  treatment,  which  is  justly  condemn- 
ed even  by  the  old  school,  is  unfortunately  practised 


126  CATARRHAL  FEVER. 

by  more  than  one  among  our  ranks  ;  but  it  is  a  mis 
chievous  mode  of  treatment,  and  accomplishes  in  a 
round-about  way,  by  a  variety  of  remedies,  what  one 
single  remedy  would  have  done  if  selected  in  accord- 
ance with  the  whole  group  of  symptoms.  All  good 
homoeopathic  physicians  will  agree  with  us  that  the 
symptomatic  method  would  be  the  grave  of  homoeo- 
pathy, and  will  not  blame  us  for  not  giving  a  detailed 
description  of  the  treatment  which  ought  to  be  pur- 
sued in  every  little  variety  of  a  disease ;  we  shall  fur- 
nish general  indications  for  the  selection  of  the  proper 
remedy  in  every  case. 

One  of  the  principal  remedies  against  catarrhal 
fevers  is  Aconite,  especially  when  they  are  occasioned 
by  a  cold,  by  dry  and  cold  weather,  north-westerly 
winds  or  by  a  current  of  air,  and  when  the  following 
symptoms  occur  :  Creeping  chills  with  burning  skin, 
hot  forehead,  great  thirst,  especially  in  the  evening,  ac- 
companied with  a  sensation  of  dryness  and  scraping, 
slight  burning  and  soreness  in  the  throat,  especially 
in  the  region  of  the  larynx,  or  extending  even  through 
the  whole  chest,  inducing  continual  turns  of  a  short, 
dry  cough,  which  is  rather  rough  and  hollow  in  the 
night,  and  interrupts  the  sleep ;  this  is  moreover  dis- 
turbed by  vivid  fancies,  especially  after  midnight. 

Another  remedy,  which  is  frequently  indicated,  is 
Nux  vomica ;  it  corresponds  to  the  following  symptoms : 
inclination  to  chilliness,  erratic  shiverings,  as  if  passing 
over  the  bones,  now  in  one,  now  in  another  part  of  the 
organism,  mostly  during  motion,  alternating'  with 
flushes  of  heat,  coming  on  in  the  afternoon  and  in- 
creasing progressively.  These  ailments  are  relieved  by 
remaining  quiet,  near  a  warm  stove.  They  are  some- 
times accompanied  with  a  scraping  sensation  in  the 
pharynx,  which  is  particulary  experienced  in  the  morn- 
ing hours,  and  induces  a  roughness  of  speech  obliging 
the  patient  to  hawk  frequently  or  to  cough.  One 
of  the  characteristic  symptoms  of  Nux  is  the  titillation 
which  is  caused  by  the  scraping  sensation  below  the 
larynx  ;  the  scanty  expectoration  of  tenacious  mucus, 
the  light  scraping  cough  in  daytime,  less  in  the  night, 


CATARRHAL  FEVER.  127 

and  more  frequently  in  the  morning  hours,  are  like- 
wise characteristic  of  Nux.  Nux  is  likewise  the  prin- 
cipal remedy  when  the  dry,  wearing  cough  is  accom- 
panied with  a  painful  feeling  as  if  bruised  in  the 
umbilical  region,  which  is  moreover  sensitive  to 
pressure. 

Conium  maculatum,  middle  attenuations,  is  the  best 
remedy  for  fevers  characterized  by  the  following  symp- 
toms :  internal  dry  heat  with  much  thirst,  great  lassi- 
tude, scraping,  itching,  and  creeping  in  the  throat, 
inducing  an  almost  uninterrupted  dry  cough  with  titil- 
lation.  The  urine  is  whitish  and  turbid,  the  sleep 
unrefreshing,  disturbed  by  many  anxious  dreams  ;  the 
patient  dreads  every  little  noise  or  talking  on  account 
of  the  sensitiveness  of  the  head,  which  is  either  excited 
or  aggravated  by  it. 

Dulcamara  corresponds  to  catarrhal  fevers  which 
have  been  evidently  caused  by  a  cold,  by  a  sudden  sup- 
pression of  the  perspiration,  and  are  characterized  by 
roughness  and  hoarseness  of  the  throat,  cough  with 
mucous  expectoration,  violent  fluent  coryza,  great 
heat,  dryness  and  burning  heat  of  the  skin.  In  many ' 
cases  of  epidemic  catarrhal  fever  Dulcamara  is  like- 
wise indicated  by  a  dry,  rough  cough. 

Drosera  is  one  of  the  best  remedies  in  catarrhal 
fevers,  when  the  patient  is  attacked  with  a  sensation 
as  if  all  his  limbs  were  bruised  and  paralyzed,  one' 
when  the  usual  catarrhal  symptoms  are  accompanies 
with  frequent  shudderings  over  the  whole  body,  col( 
hands,  and  hot  countenance.  The  catarrhal  symptoms 
indicate  Drosera  when  the  larynx  is  principally  affect- 
ed, when  there  is  hoarseness,  cough  excited  by  a  sen- 
sation of  roughness  and  scraping  in  the  fauces;  some- 
times the  inmost  parts  of  the  chest  are  irritated. 

Euphrasia  is  to  be  employed  in  catarrhal  fevers, 
when  the  chilliness  is  more  frequent  than  the  heat, 
•when  the  heat  is  merely  an  incidental  symptom,  and 
\vhen  the  following  symptoms  occur:  inflammatory 
irritation  of  the  mucous  membranes  of  the  eyes, 
lachrymation,  photophobia,  nightly  agglutination,  heat 


128  CATARRH AL  FEVER. 

in  the  head,  and  painful  sensation  as  if  the  head  were 
bruised,  sensation  as  if  the  skull  would  burst,  frequent 
fluent  coryza,  painfulness  of  the  inner  nose,  sneezing; 
violent  cough  with  expectoration,  especially  in  the 
morning. 

Similar  symptoms  indicate  Mercurius  sol. ;  it  is  not 
always  easy  to  decide  which  of  the  two  remedies,  Eu- 
phrasia  or  Merc.,  is  preferable ;  a  sensation  of  fulness 
in  the  head,  pulsations  in  the  head  re  aching  as  low  down 
as  the  nose,  general  heat  to  which  the  chilliness  is  mere- 
ly incidental,  indicate  Merc,  rather  than  Euphrasia.* 

Mezereum  may  be  employed  against  the  following 
group  of  symptoms  :  violent  fever  consisting  of  alter- 
nate chills  and  heat,  the  chill  being  more  violent  out  of 
the  bed,  the  heat  more  violent  when  the  patient  is  in  the 
bed,  great  sensitiveness  to  cold  air,  acrid  discharge  from 
the  nose,  cough  arising  from  a  burning  irritation  in 
the  larynx  and  trachea,  and  difficulty  of  throwing  off 
the  mucus. 

Every  observing  practitioner  is  acquainted  with  the 
go  id  effects  of  Chamomilla  in  catarrhal  fever,  espe- 
cially when  the  following  symptoms  prevail :  synochus, 
both  the  chilliness  and  heat  being  moderate ;  the  chil- 
liness consists  of  slight  chills  which  are  experienced 
only  in  certain  portions  of  the  organism,  generally  in 
those  parts  which  the  patient  uncovers ;  hence,  the 
chills  are  frequently  experienced  when  the  patient  lifts 
the  cover  of  his  bed ;  sometimes  the  chilliness  and  heat 
are  mixed :  while  one  portion  of  the  body  feels  cold  as  ice, 
the  other  is  burning  hot.  the  heat  being  principally  felt 
on  the  cheeks.  The  sleep  is,  of  course,  disturbed  by 
the  febrile  condition ;  starting  from  sleep  as  if  in  af- 

*  Such  colds  are  very  obstinate  in  this  region  of  our  country.  When  the 
nose  has  not  yet  commenced  running,  and  feels  swollen  internally,  Hahne- 
mann  advises  Nux  as  a  preventive.  If  the  Mercurius  be  required,  one  dos« 
of  Merc.  200,  will  be  found  to  be  sufficient  in  some  cases  ;  in  others,  however, 
we  have  to  use  Mercurius  3,  in  powders,  one  every  three  hours.  My  rule 
then  is,  to  continue  these  powders  until  every  vestige  of  the  cold  has  disap- 
peared, which  sometimes  requires  10, 15,  or  even  20  powders  in  succession.  To 
speed  the  cure  the  patient  ought  to  live  as  low  as  possible,  on  gruel,  weak 
tea,  toast,  etc.,  and  avoid  all  stimulating  dishes.  The  saying,  "  Feed  a  cold 
and  starve  a  fever,"  implies  a  vulgar  and  foolish  practice. — HEMPEL. 


CATARRHAL  FEVER.  129 

fright,  and  shrieking  while  sleeping,  are  character- 
istic indications  for  Chamomilla,  especially  when  those 
symptoms  occur  during  the  period  of  dentition.  The 
catarrhal  irritation  is  principally  perceived  in  the  mu- 
cous membranes  of  the  respiratory  organs,  nose,  and 
frontal  cavities — hence,  the  violent  dry  cough,  espe- 
cially at  night,  occasioned  by  a  constant  titillation  in 
the  larynx,  accompanied  with  hoarseness  and  rattling 
of  mucus  in  the  trachea.  When  this  cough,  arising 
from  a  titillation  in  the  larynx,  exists  only  in  the  night, 
it  is  generally  relieved  by  Hyosciamus.  If  it  continue 
night  and  day  without  change,  Ignatia  is  the  best 
remedy. 

Among  the  symptoms  of  Hepar  sulphuris  we  discover 
a  catarrhal  fever,  characterized  by  internal  chilliness, 
and  ill  humour,  or  heaviness  in  all  the  limbs.  This 
remedy  is  on  a  par,  and  constitutes  a  group,  with  Eu- 
phrasia  and  Nux  ;  it  is  most  frequently  indicated  when 
the  mucous  membrane  of  the  eyes  is  affected,  when  the 
patient  experiences  a  painful  pressure  in  the  eyes,  when 
the  conjunctiva  looks  puffy  and  red,  and  the  lids  are 
swollen.  Hepar  is  likewise  indicated  when  the  respira- 
tory organs  are  affected,  the  patient  suffers  with  a  moist 
cough  and  rattling  of  mucus  in  the  chest,whenthe  cough 
is  accompanied  with  an  intense  pain  in  the  larynx  and 
roughness  of  voice,  and  when  the  patient  complains  of 
weakness  of  the  chest  which  scarcely  allows  him  to 
speak.  The  vascular  and  nervous  systems  are  but 
moderately  irritated. 

Lachesis  is  said  to  cure  a  kind  of  catarrhal  fever 
characterized  by  heat,  fulness  of  the  head,  drawing  in 
the  teeth  and  facial  bones,  glistening  eyes  as  when  one 
feels  exhausted,  irritable  disposition,  restlessness,  mal- 
aise, some  discharge  from  the  nose.  We  have  used 
this  remedy  with  success  in  a  few  cases,  when,  after 
the  slightest  and  scarcely  perceptible  cold,  a  violent 
fluent  coryza  would  set  in  with  sneezing,  confusion 
of  the  head,  great  warmth  in  the  internal  parts  of  the 
forehead,  hot  nose,  and  general  disagreeable  warmth 
over  the  whole  body,  with  great  heat  of  the  hands  and 
feet.  In  using  Lachesis  for  those  symptoms,  we  have 
6* 


130  CATARRH AL  FEVER. 

even  seen  the  great  sensitiveness  for  external  at- 
mospheric influences  disappear  entirely. 

One  of  the  most  .distinguished  remedies  in  violent 
catarrhal  fevers  is  Arsenic.  The  Arsenic  fever  is 
characterized  by  great  heat,  intense  thirst,  yawning, 
stretching,  and  a  prostrating  sensation  of  weakness 
through  the  whole  body,  lancinating  pains  in  the  limbs 
and  head,  oppression  of  the  chest.  The  local  irritation 
of  the  mucous  membrane  frequently  ceases  during  the 
night,  especially  if  the  patient  perspire  some  ;  next 
morning,  however,  it  returns,  a  profuse  quantity  of 
watery  mucus  flowing  from  the  nose,  with  burning 
from  the  nose  and  a  sensation  as  if  the  nose  were  en- 
larged, and  as  if  it  were  swollen  in  the  region  of  the 
root ;  accompanying  those  symptoms  the  patient  ex- 
periences a  feeling  of  dryness  and  burning  in  the 
larynx,  the  irritation  occasioning  a  continual  dry  cough. 

No  less  important  in  catarrhal  fevers  than  any  of  the 
other  remedies  is  Ruta  graveolens,  when  the  following 
symptoms  appear :  general  shuddering  over  the  whole 
body,  even  near  the  warm  stove,  with  coldness  of  the 
hands  and  feet  to  the  touch,  dulness  and  warmth  in  the 
head,  violent  thirst  which  disappears,  however,  after 
drinking.  Ruta  is  moreover  indicated  by  the  sneezing, 
lachrymation,  and  by  a  pain  in  the  eyes,  as  if  they  had 
been  fatigued  by  exerting  them  too  much  ;  a  charac- 
teristic symptom  of  Ruta  is  a  contusive  pain  in  the 
region  of  the  larynx  and  a  crowing  cough  which  wakes 
the  patient  about  midnight,  is  rarely  accompanied  with 
expectoration  and  then  only  in  small  quantity,  induces 
vomiting  when  it  lasts  too  long,  and  excites  a  pain  in 
the  sternum. 

Pulsatilla  corresponds  to  catarrhal  fevers  charac- 
terized by  the  following  group  of  symptoms  :  huski- 
ness,  scraping  in  the  throat,  occasioning  a  dry, 
spasmodic,  titillating  cough,  which  is  especially  violent 
toward  evening  and  when  lying  down,  is  very  debili- 
tating during  the  night,  prevents  sleep,  abates  when 
sitting  up,  commences  again  after  lying  down,  and 
sometimes  increases  unto  suffocation,  retching,  and 
even  vomiting.  The  chilliness  is  principally  felt  to- 


CATARRH AL  FEVER.  131 

ward  evening ;  the  heat  appears  only  by  dint  of 
coughing,  and  then  becomes  excessive  and  continues 
all  night,  even  after  the  cough  abates. 

Rhus  is  likewise  useful  in  those  fevers  when  the 
titillation  and  cough  are  not  felt  in  the  larynx,  but  in 
the  bronchial  ramifications,  when  the  cough  shortens 
the  breathing  and  is  especially  violent  in  the  morning, 
thereby  preventing  the  patient  from  falling  asleep 
again.  In  general  Rhus  is  indicated  when  the  catar- 
rhal  affection  extends  over  a  large  extent  of  the 
bronchial  ramifications.  As  regards  the  fever,  this 
remedy  corresponds  to  Pulsatilla,  except  that  the 
evening  exacerbation  is  characterized  by  a  predomi- 
nance of  heat,  drawing  and  stretching  in  the  limbs, 
and  slight  creeping  chills. 

Bryonia  corresponds  to  catarrhal  fevers  accom- 
panied by  cough,  which  produces  retching,  and  some- 
times vomiting  of  the  ingesta,  with  sensation  as  if  the 
chest  would  fly  to  pieces,  and  with  profuse,  violent 
fluent  coryza,  and  pain  in  the  forehead  which  is  re- 
lieved by  pressure  upon  the  forehead ;  the  right  side 
of  the  body  is  colder  than  the  left,  and  the  patient 
complains  of  great  thirst. 

Ammonium  carbonicum  should  be  resorted  to  in 
catarrhal  fevers  characterized  by  hoarseness  and  pro- 
fuse fluent  coryza,  especially  when  an  acrid,  burning 
water  flows  from  the  nose ;  by  morning  cough  with 
titillation  or  retching,  and  with  alternation  of  chilli- 
ness and  heat.  Causticum  may  be  used  when  a  sen- 
sation of  soreness  and  excoriation  is  experienced  in  the 
trachea  (All.  horn.  Zeit.  XXVI.  93). 

Sepia  is  indicated  in  catarrhal  fevers  where  the 
chilliness  is  continual  and  occurs  upon  every  move- 
ment in  the  warm  room  ;  the  heat  is  merely  inciden- 
tal ;  the  Sepia  catarrh ul  fever  is  moreover  charac- 
terized by  a  nightly  spasmodic  cough,  which  increases 
even  unto  vomiting  and  suppression  of  breath ;  sneez- 
ing, violent  fluent  coryza,  ulcerative  pain  in  the  occiput 
and  drawing  in  the  hips  and  thighs  are  likewise 
present, 

Among  the  remedies  which  we  have  so  far  indicated 


132  CATARRHAL  FEVER. 

for  catarrhal  fevers,  the  following  require  particular 
consideration,  when  the  dry  cough  is  accompanied  by 
a  sort  of  spasm  in  the  larynx  which  does  not  abate 
until  the  patient  has  thrown  off  a  quantity  of  mucus 
after  a  good  deal  of  gagging:  Ipec.,  Nux,  Pulsat., 
Rhus,  Bryon.,  Bellad., Sepia,  Ammonium  carb..  Drosera, 
Mercurius.  The  whole  group  of  symptoms  is  some- 
times at  once  removed  by  the  homoeopathic  specific  ; 
or,  at  any  rate,  the  cough  is  changed  to  a  simple  ca- 
tarrhal cough  which  will  be  easily  removed  by  one  of 
those  remedies  which  have  been  mentioned  in  the 
preceding  paragraphs. 

For  a  dry,  spasmodic  cough,  or  a  cough  occasioned 
by  a  simple  irritation  of  the  throat,  the  principal  re- 
medies are :  Hyosciamus,  Drosera,  Lactuca  virosa, 
Conium,  Ipec.,  Bell.,  Magnes  mur.,  Phosphorus,  Ambra, 
Iodine.  Such  an  intolerable,  racking,  spasmodic  cough, 
arresting  the  breathing  on  account  of  a  titillation  in 
the  upper  part  of  the  windpipe  which  is  unencum- 
bered by  phlegm,  and  rousing  the  patient  from  sleep 
at  1 1  o'clock  in  the  night,  has  frequently  been  cured  by 
a  single  dose  of  Belladonna. 

The  hoarseness  accompanying  catarrhal  fevers,  no 
matter  whether  there  is  a  cough  or  not,  or  whether  it 
is  dry  or  moist,  yields  to :  Puls.,  Mercur.,  Drosera, 
Spong.,  Dulcam.,  Sulp.,  Tart,  emet.,  Manganum  carb. 
or  acet.,  Lachesis,  Phosphor.,  Natrum  mur.,  Sepia, 
Carbo  veg. ;  the  latter  remedies  are  especially  indi- 
cated if  the  hoarseness  increase  in  the  evening  hours. 

Nux  is  very  useful  for  a  morning  cough  \vith  titilla- 
tion and  difficult  expectoration,  remaining  after  a 
catarrh ;  Iodine  and  Kal.  hydriodicum  will  still  more 
frequently  be  found  useful. 

Chronic  catarrhs  are  akin  to  phthisis,  and  require 
the  same  care  as  the  latter  ;  there  is  no  essential  dif- 
ference between  chronic  catarrhs  and  phthisis,  for  the 
same  remedies  are  used  for  either  :  we  therefore  take 
this  opportunity  of  referring  to  the  phthisical  affec- 
tions in  the  second  volume,  where  we  shall  treat  of 
them  more  in  detail.  We  will  here  simply  state,  that 
the  following  remedies  have  been  found  useful  in 


CATARRHAL  FEVER.  133 

chronic  catarrhs,  the  last  of  them  principally,  when 
the  expectoration  seemed  loose  and  yet  could  not  be 
thrown  off: — Tart,  emet.,  Drosera,  China,  Dulcamara, 
Stannum,  Manganum,  Carbo  veg.,  Iodine,  Bromine, 
Amm.  mur.  According  to.  Goullon,  Lycopodium  cor- 
responds to  those  obstinate  catarrhs  where  a  lemon- 
coloured  and  frequently  bitter  phlegm  is  thrown  off, 
accompanied  by  a  violent  tearing  beating  pain  in  the 
frontal  cavities,  with  afternoon  or  evening  exacerba- 
tions. 

It  is  well  known  that  catarrhal  fevers  frequently 
unite  with  gastric  or  typhoid  symptoms,  inflammations, 
and  cutaneous  eruptions ;  in  such  cases  the  remedy 
has  to  be  chosen  in  accordance  with  the  symptoms  of 
that  affection  which  are  most  marked. 

§  33.    Catarrhal  Fever  in  Children. 

We  ought  not  to  omit  mentioning,  on  this  occasion, 
a  catarrh  or  catarrhal  fever  of  children  which  can  only 
be  observed  by  the  physician,  but  cannot  be  investi- 
gated by  questioning  the  patient.  The  pathology  and 
treatment  of  this  fever  do  not  differ  essentially  from 
the  one  above  described.  It  is  characterized  by  sneez- 
ing, running  of  the  nose  and  eyes,  cough,  hoarseness, 
and  in  small  children  rattling  arising  from  the  mucus, 
which  they  have  not  strength  enough  to  throw  off. 

Aconite,  two  or  three  doses  a-day,  is  the  principal 
remedy  when  the  following  symptoms  occur :  burning 
heat  of  the  whole  body,  accelerated  pulse  and  breath- 
ing, dry,  short  cough,  the  infant  screaming  sometimes 
as  if  it  would  manifest  pain.  If  the  heat  be  less 
marked,  the  cough  loose  with  constant  irritation  in  the 
air-passages,  and  if  rattling  be  present,  we  know  of 
no  better  remedy  for  those  symptoms  than  Antimonial 
wine,  one,  two,  or  three  drops  a-day ;  this  remedy  fre- 
quently removes  the  symptoms  more  rapidly  than 
Chamomilla,  which  is  likewise  indicated.  In  catarrhal 
fevers,  Euphrasia  suits  children  frequently  better  than 
full-grown  persons,  the  profuse  running  from  the  nose 
being  frequently  accompanied  by  a  considerable  red- 
ness of  the  whites  of  the  eyes,  lachrymation  and  slight 


134  CATARRHAL  FEVER. 

agglutination.  As  regards  other  remedies,  we  refer  to 
those  indicated  for  the  catarrhal  fever  of  full-grown 
persons,  reminding  our  readers  particularly  of  Bella- 
donna and  Piilsatilla. 

The  dry  coryza  is  still  more  troublesome  than  the 
fluent ;  the  former  hindering  the  infant's  taking  the 
breast  and  causing  it  to  scream  and  to  be  restless.  This 
condition  arises  from  the  suppression,  in  consequence 
of  cold,  of  a  fluent  coryza,  causing  a  disagreeable 
dryness  of  the  nose,  \vhich  brings  on  the  difficulty  of 
taking  the  breast.  This  affection  frequently  lasts  a 
long  while,  becomes  worse  in  warmth,  and  decreases 
in  the  open  air,  where  the  running  from  the  nose  is 
generally  restored.  It  befalls  not  only  small,  but  even 
larger  children,  inducing  a  habit  of  breathing  with  an 
open  mouth. 

The  trouble  is  frequently  removed  by  rubbing  the 
dorsum  of  the  nose  with  a  greasy  substance,  such  as 
hen's  grease,  almond  oil,  or  thick  cream  ;  or  by  causing 
the  vapour  of  warm  milk  to  pass  into  the  nose.  ,  Inas- 
much as  the  trouble  is  chiefly  owing  to  the  nasal 
mucus  not  being  secreted  in  a  sufficient  quantity,  it  is 
certainly  a  good  plan  to  replace  the  natural  mucus  by 
an  oily  substance,  say  almond  oil,  with  which  the  inner 
walls  of  the  nose  may  be  lined  by  means  of  a  fine 
feather. 

If  this  palliative  means  should  not  be  sufficient  to 
remove  the  trouble,  an  internal  remedy  will  then  have 
to  be  resorted  to,  and  will  have  to  be  selected  in  ac- 
cordance with  all  the  concomitant  symptoms.  A 
small  dose  of  Nux  will  prove  the  best,  if  the  dry 
coryza  increase  in  the  evening,  accompanied  by  great 
dryness  of  the  mouth,  whereas  the  fluent  coryza  pre- 
vails in  the  daytime.  Other  physicians  pretend  to 
have  removed  the  trouble  by  repeated  doses  of 
Sambucus.  In  some  cases,  where  the  obstruction  of 
the  nose  was  accompanied  by  a  profuse  discharge  of 
mucus,  Chamomilla  proved  curative ;  Dulcamara  is 
the  best  remedy  \vhen  the  dry  c.pryza  increases  in  a 
cool  and  decreases  in  a  warm  temperature.  Carbo 
veg.  deserves  consideration  in  obstinate  cases,  with 


INFLUENZA.  135 

evening  exacerbation  ;  Graphites,  when  great  debility 
and  prostration  prevail. 

If  the  dry  coryza  set  in  while  the  children  are  still 
at  the  breast,  or  if  the  mother  be  affected  with  it,  the 
latter  may  take  the  medicine  alone. 

§  34.  hifluenza. 

The  influenza  is  not  an  indigenous  disease  with  us 
(in  Germany) ;  the  grippe  still  less  so ;  when  the 
cholera  appeared  amongst  us,  both  affections  frequent- 
ly appeared  in  company  with  it,  and  have  ever  since 
become  stationary  diseases,  the  grippe  at  least.  Both 
grippe  and  influenza  are  varieties  of  a  catarrhal  fever, 
being  subject  to  the  same  therapeutic  rules  as  the 
fever,  and  every  other  disease.  For  the  benefit  of  be- 
ginning homo3opathic  practitioners  we  here  record  our 
experience  of  the  treatment  of  those  affections ;  what 
we  shall  say  is  derived  from  the  most  careful  observa- 
tion. 

The  influenza,  like  every  catarrhal  fever  of  a  certain 
degree  of  violence,  commences  with  striking  debility 
and  drowsiness ;  subsequently  shiverings  and  even 
chilliness  over  the  whole  body  make  their  appearance. 
The  usual  catarrhal  symptoms  are  :  sensitiveness  of 
the  eyes,  lachrymation,  pressure  in  the  eyes,  with 
slight  redness  ;  aching  pain  in  the  forehead,  fluent 
coryza,  in  some  cases  dry  coryza ;  short  turns  of  dry 
cough,  which  fatigues  the  chest,  are  not  wanting ; 
they  are  accompanied  with  want  of  appetite,  and  a 
white-coated  but  dry  tongue ;  dryness  of  the  throat, 
and  afterwards  a  dry,  burning  heat,  \vith  great  thirst. 

Many  cases  of  influenza,  especially  those  which  are 
characterized  by  constipation,  are  often  relieved  by  a 
dose  of  Nux  in  a  few  hours,  provided  the  dose  was 
proportionate  to  the  intensity  of  the  disease  and  the 
patient's  individuality ;  sometimes,  however,  Arsenic  is 
more  suitable,  especially  when  debility,  diarrhoea, 
great  thirst  and  a  paralytic  sensation  in  the  limbs  are 
the  prominent  symptoms.  Causticum  has  been  found 
very  useful,  which  was  followed  a  few  hours  after  by 
Camphor.  Both  those  remedies  were  administered  by 


136  GRIPPE. 

olfaction.  Of  the  latter  remedy  Hahnemann  remarks:  * 
"If  the  Siberian  influenza  attack  one  of  us  (in  Germany), 
and  the  heat  have  already  set  in,  Camphor  may  be 
used  as  a  palliative,  on  account  of  the  disease  having 
but  a  short  run  ;  it  is  an  excellent  palliative  when  ad- 
ministered in  frequent  and  progressively  increased 
doses.  Camphor  does  not  shorten  the  course  of  the 
disease,  but  diminishes  its  violence,  and  removes  all 
danger  until  its  termination." 

§  35.  Grippe. 

Another  species  of  catarrhal  fever  is  the  grippe, 
which  prevailed  at  the  commencement  of  the  year 
1833.f  The  symptoms  of  grippe  are  much  more  varied 
and  complicated  than  those  of  influenza ;  and  the 
disease,  when  invading  the  organism  suddenly,  was 
much  more  dangerous,  and  sometimes  led  to  fatal  re- 
sults. If  a  patient,  whose  chest  was  affected,  had  an 
attack  of  the  grippe,  consumption  was  generally  the 
result  of  that  complication ;  in  very  few  cases  only  it 
was  possible  to  save  the  patient's  life.  Generally,  an 
attack  of  the  grippe  came  on  suddenly — in  a  few  cases 
only  the  disease  developed  itself  gradually  ;  it  was 
distinguished  from  any  other  catarrhal  disease  by  an 
unusual  lassitude,  heaviness  and  a  bruised  feeling  in 
the  limbs,  especially  the  lower.  At  times  this  prostrate 
feeling  of  the  limbs  was  accompanied  with  headache 
and  an  inclination  to  vomit,  at  times  with  sore  throat 
and  some  hoarseness.  Sometimes  the  dry  coryza  be- 
came very  violent,  and  was  accompanied  with  a 
violent  and  frequently  intolerable  tearing  pain  in  the 
forehead,  affecting  the  facial  bones,  with  pressure  in 
the  remaining  portion  of  the  head,  vertigo,  otalgia, 
painful  swelling  of  the  parotids,  etc.  The  disease  had 
many  peculiar  features,  for  instance  :  in  persons  who 
were  not  entirely  well,  it  would  excite  the  former 
symptoms  which  had  become  latent,  thus  making  the 
cure  so  much  more  difficult ;  it  would  attack  the 

*  See  Hahnemann's  Materia  Med.  Pura,  by  Charles    J.  Hempel,  M.  D., 
Vol.  I.,  preface  to  Camphor, 
t  See  All.  horn.  Zeit.,  Vol.  II.,  p.  187,  etc. ;  also,  Archiv,  Vol.  XIII.,  2,  p.  88. 


GRIPPE.  137 

same  person  several  times,  but  always  under  another 
form  ;  sometimes  it  would  last  a  considerable  while  in 
a  mild  form,  but  the  symptoms,  although  easily  yield- 
ing to  suitable  remedies,  would  be  excited  again  by 
the  least  error  in  diet,  sometimes  even  the  next  day. 
Another  peculiarity  of  the  grippe  was  its  tendency  to 
unite  with  other  diseases,  modifying  their  course  and 
aggravating  the  whole  condition.  Dr.  Bosch  (see 
Hygea,  XIX,  p.  328),  found  that  fetid  sweats  and 
erysipelatous  eruptions  constituted  critical  phenomena 
in  grippe,  and  therefore  proposes  to  designate  the  dis- 
ease as  a  febris  erysipelacea  epidemica. 

As  soon  as  the  first  symptoms  of  the  disease  made 
their  appearance,  it  was  an  easy  thing  to  suppress  it 
by  smelling  a  few  times  of  Camphor  j  after  some 
time  it  broke  out,  nevertheless.-  This  was  not  the 
case  in  an  epidemic  grippe  which  broke  out  afterwards, 
and  for  which  the  first  attenuation  of  Camphor  taken 
internally  proved  the  most  sovereign  remedy  (see  All. 
horn.  Zeit.  XXV.  61).  When  an  inflammatory  con- 
dition of  the  thoracic  organs  was  a  predominant 
symptom,  Nux  was  always  found  an  excellent  remedy 
after  Aconite.  Merc.  sol.  or  Merc,  vivus  was  prefer- 
able when  the  head,  throat,  and  chest  were  violently 
affected,  and  \vhen  a  dry,  racking  cough,  which  after- 
wards became  loose,  was  present ;  when  the  patient 
complained  of  pains  in  the  pleura,  with  profuse  sweats 
which  did  not  afford  him  any  relief ;  when  the  con- 
dition of  the  liver  exhibited  inflammatory  symptoms, 
the  pain  being  rather  dull,  and  the  pulse  not  very 
hard  ;  a  few  doses  of  Mercurius  a-day  were  sufficient 
to  remove  and  even  to  suppress  the  disease  in  the  very 
beginning.  Phosphorus  was  the  best  remedy  when 
the  trachea  was  irritated  or  inflamed,  and  when  the 
intense  pain  prevented  speech,  or  when  the  voice  was 
very  much  altered. 

Sometimes  the  disease  assumed  the  form  of  sporadic 
cholera ;  in  that  case  the  catarrhal  symptoms  were 
inconsiderable,  but  the  debility  so  much  more  marked. 
Veratrum  was  the  specific  for  that  group  of  symptoms. 
If,  in  the  course  of  the  disease,  typhoid  symptoms  set 


138  GRIPPE. 

in,  as  was  frequently  the  case  in  the  later  periods  of 
the  epidemic ;  if  the  patient  became  delirious,  had  a 
wild,  staring  look,  complained  of  great  sensitiveness 
of  the  abdomen,  with  a  full,  hard  pulse,  Aconite  was 
given  with  great  effect ;  the  remaining  symptoms 
yielded  to  Pulsatilla.  This  remedy  frequently  re- 
moved the  papescent,  insipid  taste  which  sometimes 
remained  a  long  time,  accompanied  with  slimy  coating 
of  the  tongue  and  want  of  appetite. 

An  exceedingly  distressing  symptom  in  that  disease 
•was  the  violent  pressing,  aching  pain  in  the  forehead  ; 
this  pain,  together  with  the  accompanying  cough,  and 
the  loose  and  slimy  expectoration,  yielded  to  Bryonia, 
which  was  likewise  the  principal  remedy  when  the  liver 
was  distended,  and  the  region  of  the  liver  was  painful 
to  the  touch,  or  when  the  pain  was  excited  by  coughing 
or  taking  a  deep  inspiration.  Bryonia  was  also  the 
specific  remedy  for  the  cough  when  it  readily  excited 
vomiting,  or  occasioned  a  pain  in  the  epigastric  region 
(in  which  case  Bryon.  and  Nux  were  equally  indicated), 
and  a  pain  as  if  bruised  under  the  short  ribs,  obliging 
the  patient,  while  coughing,  to  press  his  hands  against 
the  region  where  this  pain  was  experienced.  Bryonia 
was  given  alternately  with  Carbo  veg.,  in  a  form  of 
grippe  with  which  old  people  were  sometimes  attacked, 
and  which  was  characterized  by  great  distress  in  the 
chest  and  coldness  of  the  limbs ;  this  form  frequently 
terminated  fatally  in  paralysis  of  the  lungs.  If  the 
cough  was  dry,  spasmodic ;  if  the  headache  became,  in- 
tolerable, if  it  was  increased  by  walking,  talking,  bright 
light,  movement ;  if  the  patient  had  a  staring  look,  and 
saw  all  sorts  of  fanciful  images  on  closing  the  eyes, 
Belladonna  was  the  remedy  ;  and  after  using  it  for  a 
couple  of  hours,  the  symptoms,  although  bordering 
upon  encephalitis,  had  disappeared. 

Rhus  was  indicated  if  the  grippe  had  come  on  in 
consequence  of  getting  wet,  and  the  attack  was  charac- 
terized by  oppressive  anxiety, frequent  turns  of  involun- 
tary, deep  breathing,  restlessness  of  the  body,  and  if  the 
patient  was  constantly  changing  his  place  of  rest. 

Sabadilla  was  the  remedy  when  the  grippe  took  the 


GRIPPE.  139 

form  of  an  inflammatory  affection  of  the  organs  of  the 
chest,  accompanied  with  violent  chilliness  and  external 
coldness. 

China  removed  the  cough  which  commenced  with, 
and  seemed  to  arise  from  a  rattling  behind  the  sternum, 
as  if  mucus  had  accumulated  in  that  region. 

An  exhausting  cough,  with  difficult  expectoration, 
and  every  paroxysm  being  followed  by  yawning, 
yielded  to  Opium,  a  number  of  other  remedies  having 
previously  been  tried  in  vain. 

The  alcoholic  tincture  of  Sulphur  was  found  useful 
towards  the  termination  of  the  disease,  when  the 
fever  was  abating,  and  when  the  patient  experienced 
the  stitches  in  the  chest  only  during  a  deep  inspira- 
tion, or  a  violent  paroxysm  of  cough,  oppression  of  the 
chest  as  if  a  heavy  load  pressed  upon  the  chest,  being 
likewise  present. 

The  spasmodic  cough  which  remained  a  long  while 
after  the  disease  had  left,  and  which  frequently  tor- 
mented the  patient  for  hours,  almost  always  yielded 
to  one  or  two  doses  of  Hyosciamus,  in  single  cases  to 
Belladonna ;  if,  however,  the  nightly  paroxysm  did 
not  cease  till  the  patient  had  vomited  a  quantity  of 
frothy  mucus,  mixed  with  tips  of  yellowish  pus,  Conium 
was  the  principal  remedy ;  if  the  cough  appeared  after 
every  meal,  and  the  food  was  vomited  up  again, 
Ferrum  aceticum  was  the  specific  remedy. 

If  the  grippe  left  behind  a  troublesome  cough,  with 
gray,  saltish,  sweetish  expectoration,  wheezing  and 
rattling  in  the  chest,  Kali  hydriod.  proved  an  incom- 
parable remedy. 

When  the  grippe  threatened  to  develope  a  previously 
existing  phthisical  disposition,  a  few  doses  of  Stannum 
in  alternation  with  Carbo  veg.  were  frequently  suf- 
ficient to  remove  the  symptoms  before  phthisis  had 
been  fully  developed. 

Consecutive  symptoms  of  the  grippe  sometimes 
were  obstinate  inflammation  of  the  eyes,  with  ulcers 
of  the  cornea,  and  violent  photophobia ;  the  only 
remedy  which  removed  them  permanently  was  Arsenic ; 
repeated  doses  of  Belladonna  were  sometimes  given 
with  success,  but  the  relief  was  not  permanent. 


140 


THIRD    CLASS. 

FEVERS    WITH    LOCAL    IRRITATION    OF    THE    FIBROUS    AND 
SEROUS    TISSUES. 

§  36.  Simple  Rheumatic  Fever. 

When  an  affection  of  the  serous  and  fibrous  tissues, 
sheaths  of  muscles,  articular  membranes,  in  company 
with  the  drawing,  tearing,  burning  pains  in  the  joints 
or  trunk — the  character  of  the  pain  varying  according 
to  the  nature  of  the  tissue  which  is  the  seat  of  the 
affection — is  accompanied  by  a  more  or  less  violent, 
continuous  remittent  fever,  we  term  this  a  rheumatic 
fever.  The  accompanying  rheumatic  pains  may  come 
on  before  or  after  the  commencement  of  the  fever,  or 
may  appear  during  the  course  of  the  disease.  The 
pain  which  is  experienced  during  those  fevers  has  no 
definite  and  permanent  character ;  it  is  sometimes 
tearing,  stinging,  boring,  sometimes  drawing,  digging 
up,  jerking ;  nor  can  we  consider  swelling  and  red- 
ness of  the  locally  affected  part  characteristic  symp- 
toms, inasmuch  as  they  are  wanting  in  many  rheu- 
matic affections,  such  as  lumbago,  rheumatic  affection 
of  the  intercostal  muscles,  etc.  As  the  fever  abates, 
the  local  affection  diminishes  likewise,  leaving  in  a 
few  cases  a  chronic  trouble  behind.  The  fever  is  a 
synocha,  with  evening  and  night  exacerbations,  which 
are  accompanied  by  an  increase  of  the  local  affection. 
An  inclination  to  sweat  is  a  characteristic  symptom  of 
that  fever  ;  the  sweats,  however,  have  no  critical  im- 
portance. The  pulse  is  full,  rather  hard,  accelerated, 
sometimes  even  quite  hard,  often  unequal,  especially  so 
when  the  pericardium  is  affected,  in  which  case  the 
fever  is  very  violent ;  the  urine  is  scanty,  yellow,  red- 
dish, and  finally  becomes  cloudy  and  deposits  a  reddish, 
brick-dust  sediment.  The  thirst  is  increased  and  the 
appetite  diminished  ;  sometimes  the  tongue  is  covered 
with  a  more  or  less  thick  coating  of  a  yellowish  white 
mucus,  the  taste  is  bitter,  the  patient  inclines  to  vomit, 
the  bowels  are  confined. 

The  7th,  14th,  or  21st  day  is  the  critical  day,  the 
fever  terminating  in  a  copious,  general  sweat ;  the 


SIMPLE  RHEUMATIC  FEVER.  141 

duration  and  the  commencement  of  the  crisis  are  not 
always  marked  by  definite  periods.  Schcenlein  does 
not  recognise  any  rheumatic  fever;  he  terms  the 
rheumatic  affection  acute  rheumatism,  which  is  dis- 
tinguished from  a  rheumatic  fever  by  the  greater 
violence  of  the  local  affection,  interesting  the  attention 
of  the  patient  and  the  physician  more  than  the  fever  ; 
in  acute  rheumatism  the  redness  and  swelling  occur 
more  frequently  than  in  rheumatic  fever,  especially  if 
the  affected  part  be  near  the  surface  of  the  body. 
The  pain  in  acute  rheumatism  is  more  acute,  more 
seated,  the  fever  is  more  violent,  and  strictly  continu- 
ous. It  is  undoubtedly  improper  to  draw  a  marked 
line  of  demarcation  between  a  rheumatic  fever  and 
acute  rheumatism  ;  if  such  a  thing  were  possible,  the 
homoaopathic  treatment  would  not  be  affected  by  such 
a  division. 

§  37.  These  fevers  depend  principally  upon  atmos- 
pheric changes,  which  generally  communicate  to  those 
fevers  an  epidemic  character.  They  occur  frequently 
at  the  end  of  winter,  at  the  commencement  of  spring, 
and  during  the  damp  and  wet  fall  weather.  Exciting 
causes  are  :  getting  wet  to  the  skin,  exposure  to  a 
current  of  air,  repelled  perspiration,  etc. 

§  38.  In  most  cases  the  prognosis  is  favourable  as 
long  as  the  disease  remains  a  simple  rheumatic  fever. 
The  prognosis  is  less  favourable  when  the  fever  is 
accompanied  with  inflammation  of  important  internal 
organs,  or  when  the  articulations  of  the  spinal  column 
are  involved.  The  prognosis  is  likewise  unfavourable 
when  the  fever  lasts  a  long  time,  and  the  pericardium 
or  the  heart  itself  is  involved  in  the  disease  ;  or  when 
the  fever  settles  upon  the  brain,  and,  in  general,  when 
the  local  affection  easily  changes  its  seat. 

§  39.  The  treatment  of  these  fevers  is  just  as  varied 
as  that  of  any  other  disease  ;  it  depends  in  every  case 
upon  the  characteristic  symptoms  of  the  disease. 
Aconite  is  required  only  in  very  few  cases.  According 
to  our  experience  it  ought  to  be  given  when  the  fever 
is  intense  ;  when  the  inflammation,  hot  swelling,  red- 
ness, and  intense  pains  in  the  affected  parts  increase 


142  SIMPLE  RHEUMATIC  FEVER. 

rapidly;  in  such  a  case  Aconite  is  always  indicated 
by  other  accompanying  symptoms,  such  as :  intense 
dry  heat,  burning  dry  skin ;  full,  accelerated,  not  hard 
pulse  ;  great  thirst,  flushed  face,  or  else  alternate  red- 
ness and  paleness  of  the  face,  anxiety  and  restlessness, 
moaning  and  tossing  about,  sleeplessness,  or  else  sleep 
disturbed  with  anxious  dreams.  For  such  a  group  of 
symptoms,  the  lower  attenuations  of  Aconite,  fre- 
quently repeated,  will  prove  the  best  remedy. 

Rheumatic  fevers  which  are  characterized  by  such 
symptoms,  belong  rather  to  the  class  of  acute  rheuma- 
tism, whence  it  appears  that  Aconite  is  indispensable 
in  that  disease. 

Bryonia  is  superior  to  Aconite  when  the  nervous  and 
vascular  erethism  is  accompanied  by  tearing,  tensive, 
stinging  pains  in  the  red  and  shining  swelling  of  the 
articulation,  becoming  insupportable  during  movement 
and  during  the  night's  rest.  This  remedy  has  likewise 
to  be  repeated  in  such  fevers,  the  repetition  being  pro- 
portionate to  the  violence  of  the  fever  which  had  re- 
mained after  the  exhibition  of  Aconite.* 

Belladonna  is  a  specific  in  rheumatic  fevers  when 
the  brain  and  nervous  system  are  greatly  irritated,  and 
the  rheumatic  pains  wander  from  one  part  to  another ; 
swelling  and  light  redness  are  always  present,  and  the 
burning,  stinging  pains  in  the  affected  parts  are  most 
violent  at  night  and  when  the  parts  are  touched  ever 
so  lightly  ;  if  the  patient  should  go  to  sleep,  he  is  fre- 
quently roused  by  startings  of  the  affected  parts,  or  a 
painful  drawing  in  the  limbs  prevents  him  from  falling 
asleep.  Belladonna  is  an  excellent  remedy  when  the 
nape  of  the  neck,  the  spinal  column  and  the  small  of 
the  back  are  involved,  when  those  parts  are  painful, 
stiff  and  swollen,  when  the  rheumatic  affection  pre- 
vents every  movement  of  those  parts,  and  movement 
occasions  the  most  violent  pains ;  one  knee-joint  is 
likewise  affected,  the  patient  has  to  keep  it  bent  and 

*  A  great  rival  of  Bryonia  in  inflammations  of  the  serous  membranes  is 
Cantharides,  especially  when  there  is  a  frequent  desire  to  urinate.  In  rheu- 
matic inflammations  where  Bryonia  is  indicated  and  will  not  help,  Canthari- 
des ought  to  be  given,  and  if  neither  be  sufficient  alone,  they  ought  to  be 
given  alternately.— 


SIMPLE  RHEUMATIC  FEVER.  143 

quiet,  the  least  movement  making  the  pain  intolerable 
to  such  an  extent  that  it  will  extort  shrieks  from  the 
patient.  (When  these  symptoms  occur  Bryonia  may 
be  used  when  the  fever  approaches  more  to  the  erethic 
form.)  The  rheumatic  fevers  to  which  Belladonna 
corresponds,  are  sometimes  accompanied  with  tearing 
pains  having  the  character  of  an  ache,  and  proceeding 
from  the  inmost  parts  of  the  bones,  or  else  darting 
like  an  electric  shock  towards  the  neighbouring  artic- 
ulation, where  they  occasion  a  dull  pressure,  which  is 
relieved  by  counter-pressure,  aggravated  by  motion, 
and  increases  in  intensity  during  the  night.  The  fever 
has  generally  the  form  of  a  synocha  :  violent  burning 
heat  over  the  whole  body,  strong,  full,  accelerated 
pulse,  a  good  deal  of  thirst,  loss  of  appetite,  accom- 
panied by  a  tensive,  aching  pain  in  the  forehead,  with 
pressure  from  within  outward,  the  pain  being  increased 
by  moving  the  head  ;  the  urine  is  turbid  and  deposits 
a  reddish  sediment. 

There  is  one  remedy  which  has  been  too  little  used 
heretofore  in  rheumatism :  it  is  Colchicum.  It  deserves 
especial  consideration  at  a  time  when  rheumatism  is  a 
prevailing  disease,  and  is  of  still  greater  importance 
when  the  rheumatic  influence  prevails  in  the  transi- 
tion periods  from  winter  to  spring,  fall  to  winter,  or 
during  a  damp  and  cold,  foggy  weather.  This  remedy 
has  been  principally  used  in  the  chronic  forms  of  rheu- 
matism and  gout,  probably  owing  to  the  limited  num- 
ber of  febrile  symptoms  which  we  possess  of  that  drug. 
In  a  case  of  synochal  rheumatic  fever  where  Aconite 
seemed  to  be  required,  but  was  given  without  the  least 
benefit,  we  were  induced  to  exhibit  Colchicum  alter- 
nately with  Aconite  every  three  hours.  The  result 
was  brilliant  beyond  belief.  Since  then  we  have  used 
Colchicum  on  several  occasions,  and  have  noted  the 
following  symptoms  as  indicative  of  its  use :  the 
fever  is  a  continuous  remittent  fever,  with  afternoon 
exacerbations  ;  the  patient,  during  the  exacerbation, 
complains  of  a  progressively  increasing  dry  heat  over 
the  whole  body,  accompanied  with  palpitation  of  the 
heart  and  thirst,  sweat  breaking  out  upon  the  skin 


144  SIMPLE  RHEUMATIC  FEVER. 

suddenly,  and  disappearing  as  suddenly  ;  lancinating 
pains  in  the  affected  parts,  increasing  with  the  fever, 
being  most  violent  in  the  night,  abating  in  the  morn- 
ing, when  they  generally  wander  to  some  other  part 
which  becomes  inflamed  rapidly,  whereas  the  part 
just  left  by  the  pain  exhibits  a  simple  pale  swelling, 
which  disappears  entirely  in  the  course  of  that  day. 
For  such  symptoms  we  give  Colchicum,  third  attenu- 
ation. 

Mercurius  is  the  remedy  for  rheumatic  fevers  which 
are  characterized  by  the  following  group  of  symp- 
toms :  constant  alternation  of  chilliness  and  heat, 
or  internal  heat  accompanied  with  a  continual  chilly 
creeping  over  the  affected  parts ;  these  parts  have  to 
be  moved  all  the  time,  either  on  account  of  an  internal 
uneasiness  in  the  parts,  or  on  account  of  the  drawing- 
tearing  pains  which  are  experienced  in  them.  A  cha- 
racteristic indication  for  Mercurius  is  profuse  sweat 
which  affords  no  relief,  rheumatic  pains  in  the  head, 
limbs  and  joints,  which  are  especially  violent  at  night, 
the  slimy  coating  of  the  tongue  with  slimy  or  saltish 
taste  in  the  mouth,  complete  aversion  to  any  kind  of 
nourishment,  great  painfulness  of  the  region  of  the 
liver,  the  epigastric  region  and  the  pit  of  the  stomach, 
frequent  evacuations  of  green  mucus,  accompanied 
with  tenesmus. 

The  remedies  which  we  shall  now  mention,  corres- 
pond rather  to  those  rheumatic  fevers  which  belong  to 
the  class  of  the  erethic  fevers,  the  rheumatic  pains  be- 
ing indeed  continuous,  but  the  inflammation  of  the 
ligaments,  tendons  and  synovial  membranes,  being  less 
intense. 

First  in  rank  is  Rhus  toxicodendron.  It  is  indicated 
by  tensive,  drawing  and  tearing  pains  in  the  limbs, 
which  are  most  violent  wrhen  the  patient  is  in  a  state 
of  perfect  rest,  accompanied  by  a  sensation  of  numb- 
ness in  the  affected  parts,  and  as  if  they  had  gone  to 
sleep,  this  sensation  being  especially  experienced  in 
those  parts  upon  which  he  is  lying  ;  the  pains  are  felt 
during  the  paroxysm  of  chilliness  j  the  chilliness  al- 
ternates constantly  with  the  heat  through  the  whole 


SIMPLE    RHEUMATIC    FEVER.  145 

tx)urse  of  the  disease  ;  at  night  only  the  patient  expe- 
riences heat  with  drawing  in  the  limbs  which  occa- 
sions a  desire  to  stretch  them.  Rhus  deserves  a  pref- 
erence over  every  other  remedy  when  the  attack  has 
been  brought  on  by  wet,  penetrating  either  to  the 
whole  surface  of  the  body  or  only  to  single  parts. 

Pulsatilla  is  the  remedy,  when  the  patient,  after 
having  suffered  with  lassitude  for  several  days,  wakes 
in  the  morning  with  a  chilly  feeling  and  a  tingling 
sensation  in  the  parts  upon  which  he  had  been  lying, 
as  if  they  had  gone  to  sleep ;  the  chilliness  continues 
after  rising,  and  drawing,  jerking  pains  now  in  one, 
now  in  another  limb,  especially  in  the  long  bones,  or  a 
painful  swelling  of  the  nape  of  the  neck  supervene 
the  patient  feels  relieved  about  noon,  the  chilliness  re  • 
turns  with  increased  violence  in  the  afternoon  and 
evening,  the  pains  become  more  permanent,  the  affect- 
ed part  begins  to  swell  and  to  become  red,  the  pains 
suddenly  pass  to  some  other  part.  If  such  a  fever  oc- 
cur after  an  abuse  of  Mercury,  Pulsatilla  is  so  much 
more  necessary. 

Sometimes  such  fevers  commence  in  the  night  with 
an  oppressive  headache,  great  restlessness  of  the  body 
which  does  not  allow  any  sleep,  chills  creeping  over 
the  back,  and  sweat  breaking  out  as  soon  as  the  pa- 
tient covers  himself:  little  by  little  the  chilliness 
spreads  over  the  whole  body,  assumes  the  form  of  a 
sensation  of  internal  coldness  which  is  not  perceptible 
to  the  touch,  except  on  the  hands  and  feet,  which  are 
Icy-cold ;  gradually  he'at  supervenes  in  certain  parts 
of  the  body ;  the  head,  for  instance,  feels  hot,  with  in- 
crease of  the  headache  and  distended  veins  ;  drawing, 
tearing  pains  in  the  small  of  the  back,  in  the  back, 
knees  and  thighs,  set  in  as  the  characteristic  signs  of 
the  rheumatic  fever,  occasioning  a  lameness  or  weak- 
ness of  the  affected  parts,  and  being  aggravated  or  re- 
produced by  contact ;  those  symptoms  are  sometimes 
accompanied  by  bilious  symptoms,  such  as :  bitter 
taste  with  yellowish  coating  of  the  tongue,  bitter  eruc- 
tations, nausea,  vomiting,  thirst,  costiveness.  When 
the  above-mentioned  group  of  symptoms  occurs,  China 
7 


146  SIAIl'LE   RHEUMATIC   FEVER, 

is  the  specific  remedy,  which  requires  to  be  repeated 
more  or  less  rapidly  according  to  circumstances. 

The  Arsenic  rheumatism  sets  in  with  peculiar  symp- 
toms which  are  frequently  so  confused  that  the  physi- 
cian is  easily  led  astray  by  them,  and  is  exposed  to  the 
danger  of  misapprehending  the  disease,  unless  the 
general  character  of  the  prevailing  sickness  reveals 
the  real  character  of  the  attack.  We  find  for  instance 
paroxysms  of  anguish  without  any  previous  cause,  ac- 
companied with  pressure  and  burning  hi  the  pit  of  the 
stomach,  stitches  in  the  side,  tension  and  fulness  of  the 
abdomen  ;  after  a  shorter  or  longer  interval  those 
symptoms  are  followed  by  a  shivering,  and,  after 
quenching  the  thirst,  by  real  chilliness,  which  is  after- 
wards accompanied  by  a  drawing  and  a  burning  tear- 
ing in  the  limbs,  preventing  the  patient's  resting  upon 
those  parts,  but  being  relieved  by  warming  or  moving 
the  affected  part.  After  some  time  a  dry,  burning 
heat  with  anxiety  supervenes,  during  whieh  the  rheu- 
matic pains  become  more  violent,  and  which  is  ac- 
companied with  great  thirst.  A  characteristic  symp- 
tom of  Arsenic  is  that  the  pains  abate  as  the  swreat 
breaks  out,  whereas  in  other  rheumatic  fevers,  for 
which  other  remedies  are  indicated,  the  sweat  affords 
no  relief. 

There  is  another  kind  of  sub-inflammatory  fever 
which  is  characterized  by  drawing,  tearing  pains,  sen- 
sation of  lameness  or  numbness,  the  tendons,  ligaments 
or  bones,  are  principally  affected,  there  is  no  swelling, 
night  exacerbation ;  the  spinal" column  and  the  head 
are  involved  in  the  attack,  the  pains  extend  like  la- 
bour-pains from  the  small  of  the  back  into  the  thighs, 
making  the  least  movement  impossible,  and  the  night 
intolerable  :  such  an  attack  yields  to  Chamomile. 

Dulcamara  is  closely  allied  to  Rhus  as  a  remedial 
agent  in  rheumatic  fevers.  It  deserves  a  preference 
over  Rhus,  if  the  fever  was  not  occasioned  by  wet, 
but  by  a  sudden  retrocession  of  sweat  in  a  draft  of  air 
or  some  other  kind  of  exposure*.  A  peculiar  exciting 
cause  is  not  always  required  to  make  the  exhibition  of 
Dulcamara  necessary ;  the  exhibition  of  that  remedy 


SIMPLE    RHEUMATIC   FEVER.  147 

is  justified  when  rheumatism  is  prevalent  in  the  com- 
munity, and  the  following  group  of  symptoms  occurs : 
sticking,  drawing,  or  tearing  pains  in  the  limbs,  with 
bloatedness  of  those  parts  and  a  sensation  as  if  they 
had  gone  to  sleep  ;  violent  fever  with  great  heat ;  dry- 
ness  and  burning  of  the  skin  ;  badly  smelling  sweat 
which  affords  no  relief,  restless  tossing  about  in  the 
sleep,  occasioned  by  a  painful  sensation  of  swelling  in 
the  nape  of  the  neck  and  occiput,  which  does  not  al- 
low one  to  lie  quiet ;  drawing  pain  in  the  whole,  or 
only  in  parts  of  the  head,  involving  the  ears. 

Ranunculus  bulbosus  is  another  remedy  in  rheuma- 
tic fevers  which  has  been  too  little  considered  hereto- 
fore, and  is  related  to  China  in  this  respect,  that  the 
lancinating  pains  and  the  pains  as  if  bruised  are  readi- 
ly excited  by  contact,  movement,  or  change  of  position, 
and  that  they  are  sometimes  aggravated  by  the  con- 
tact of  a  cool  current  of  air.  The  fever,  which  is  a 
continuous  remittent  fever,  has  evening  exacerbations 
with  a  full  hard  pulse  which  should  not  induce  the 
practitioner  to  interfere  with  the  action  of  Ranunculus 
by  exhibiting  another  remedy.  The  rheumatic  fever 
for  which  Ranunculus  is  the  specific,  wanders  from 
one  part  to  another  without  affecting  any  particular- 
ly ;  it  has,  however,  one  peculiarity,  which  consists  in 
the  heat  affecting  only  one  side,  with  cold  hands  and 
feet. 

Rhododendron  chrysanthum  is  closely  allied  to  Ra- 
nunculus. The  Rhododendron  fever  is  not  very  intense, 
for  it  does  not  even  amount  to  an  erethism  of  the  vas- 
cular system,  and  consists  of  alternate  chilliness  and 
heat,  accompanied  with  pressing  pains  in  the  head 
from  within  outward,  and  drawing  in  the  limbs ;  at 
night  a  dry  heat  of  the  body  sets  in,  with  sleepless 
restlessness  ;  towards  morning  the  pains  abate,  and  a 
slight  general  sweat  makes  its  appearance.  Charac- 
teristic indications  for  Rhododendron  are  a  nightly 
drawing  tearing  in  the  periosteum,  which  is  aggra- 
vated by  bad,  changing  weather,  at  night  when  in  bed 
and  during  rest ;  these  symptoms  disappear  under  the 
use  of  Rhododendron,  as  we  know  from  experience. 


148  SIMPLE    RHEUMATIC    FEVER. 

Sulphur  corresponds  to  rheumatic  fevers  which  are 
characterized  by  a  drawing  sticking  or  a  drawing 
tearing  both  in  the  limbs  and  joints,  the  latter  being 
slightly  swollen  ;  the  pains  abate  by  external  warmth, 
and  grow  worse  in  cold ;  the  pains  are  relieved  by 
motion,  excited  by  rest ;  Sulphur  is  particularly  useful 
when  the  pains  are  seated.  Sulphur  corresponds  par- 
ticularly to  rheumatic  fevers  with  alternate  chilliness 
and  heat,  an  apprehensive  oppressive  sensation  in  the 
pit  of  the  stomach,  pains  in  the  head  and  nape  of  the 
neck,  violent  stitches  in  the  small  of  the  back ;  the 
night-sleep,  which  is  of  itself  restless,  is  moreover  dis- 
turbed by  the  violent  headache,  which  cannot  be  re- 
lieved by  any  change  of  position.  The  accompanying 
fever  is  a  continuous  remittent  fever,  with  exacerba- 
tions every  evening,  consisting  of  a  slight  chilliness 
which  commences  a  few  hours  before  falling  asleep, 
and  is  not  relieved  by  the  warmth  of  the  bed,  no  mat- 
ter how  much  covering  the  patient  may  put  on.  Not 
until  a  few  hours  have  elapsed,  great  warmth  makes  its 
appearance,  which  results  in  a  sourish-smelling  sweat 
towards  morning.  Generally  the  fever  is  accompa- 
nied with  entire  loss  of  appetite,  or  with  inclination  to 
nothing  but  sour  things,  great  thirst,  with  feeling  of 
dryness  in  the  mouth,  sour  eructations,  bloatedness  of 
the  abdomen  and  pit  of  the  stomach,  with  sensitive- 
ness to  pressure  of  those  parts,  and  insufficient,  hard 
stool. 

Characteristic  indications  for  Arnica  in  those  fevers 
are  a  tearing  with  tension  in  the  parts  which  are  af- 
fected by  the  rheumatism,  but  especially  a  lameness, 
and  pains  as  if  bruised,  redness  and  swelling  of  the  af- 
fected part,  aggravation  of  the  pains  by  the  slightest 
motion,  which  is  nevertheless  made  necessary  by  the 
uneasiness  experienced  in  the  affected  parts,  owing  to 
which  the  same  position  cannot  long  be  endured.  Ar- 
nica is  especially  applicable  in  those  febrile  rheumatic 
affections  of  the  thorax,  which  are  relieved  by  move- 
ment, and  resemble  the  .pains,  especially  in  the  poste- 
rior portion  of  fhe  thorax,  which  are  experienced  in 
consequence  of  a  bruise  or  fall.  Chilliness  and  heat 


SIMPLE    RHEUMATIC    FEVER.  149 

exist  simultaneously,  if  one  part  feels  warm,  the  other 
feels  cold. 

Cocculus  corresponds  to  those  rheumatic  fevers 
where  only  one  side  of  the  body  is  affected,  and  a  par- 
alytic drawing,  with  painful  stiffness  in  the  joints,  is 
experienced,  which  is  aggravated  by  every  movement, 
even  of  a  part  which  is  not  affected.  Cocculus  is  a 
distinguished  remedy  in  rheumatic  affections  of  the 
chest,  characterized  by  stinging,  and  a  pain  as  if 
sprained  in  the  articulations  of  the  chest  and  dorsal 
vertebrae.  If  the  paralytic  drawing  pain  affect  the 
back,  the  pain  is  generally  worst  early  in  the  morn- 
ing, is  aggravated  by  walking,  stooping,  or  talking, 
and  is  not  relieved  till  the  patient  has  been  lying  down 
for  some  time.  The  fever  consists  of  frequent  parox- 
ysms through  the  day  of  alternate  heat  and  chilliness, 
with  congestion  to  the  face,  which  constantly  remains 
pale. 

Nux  is  a  good  remedy  for  drawing,  tearing  pains, 
especially  in  the  dorsal,  lumbar,  sacral,  and  abdominal 
muscles,  in  the  latter  muscles  a  sensation  of  numbness 
and  as  if  bruised  being  experienced  at  the  same  time  ; 
those  pains  are  distinguished  by  nightly  exacerbations, 
and  do  not  admit  of  the  slightest  movement,  or  else 
require  a  constant  change  of  position  ;  they  are  accom- 
panied with  a  feeling  of  heat  over  the  whole  body 
which  deprives  the  patient  of  sleep,  with  excessive 
sensitiveness  to  all  external  impressions,  costiveness, 
and  shifting  of  flatulence  in  the  abdomen. 

As  regards  the  following  remedies,  we  content  our- 
selves with  merely  mentioning  their  names,  leaving  it 
to  the  physician  to  consult  the  Materia  Medica  for  a 
more  accurate  knowledge  of  the  symptoms. 

A  most  useful  remedy  in  such  cases,  especially  after 
an  abuse  of  Mercury,  is  Lachesis.  This  remedy  is 
indicated  in  pain  and  stiffness  of  the  joints,  with 
swelling  ;  the  pains  are  aggravated  by  movement  and 
contact,  evening  and  night ;  sweat  affords  no  relief. 

Indigo  promises  to  become  useful  in  rheumatic  fevers. 

Causticum  may  be  consulted  when  the  pains  are 
drawing  and  tearing. 


150  SIMPLE    RHEUMATIC    FEVER. 

Euphorbium,  when  the  pains  are  tearing  or  sticking, 
with  sensation  of  pressure ;  they  are  aggravated  by 
rest,  relieved  by  movement. 

Carbo  vegetabilis,  when  the  pains  are  drawing, 
tearing,  with  sensation  of  lameness,  and  arrest  of 
breathing,  characterizing  the  affection  of  the  chest, 
flatulence. 

Mezereum  for  tearing,  drawing,  and  tensive  pains 
in  the  long  bones,  with  night  exacerbation,  and  especi- 
ally if  Mercurius  in  allopathic  doses  have  been  previ- 
ously given  for  syphilis.  This  latter  indication  applies 
likewise  to  Carbo  vegetabilis. 

Valeriana  is  excellent  in  rheumatic  fevers,  when 
the  joints  are  principally  affected.  There  are  other 
remedies  for  rheumatic  fevers,  which  we  do  not  men- 
tion on  account  of  the  little  use  which  has  been  made 
of  them  in  practice. 

The  most  frequent  metastasis  occurring  in  rheumatic 
fevers  is  to  the  pericardium ;  as  we  shall  treat  of  that 
affection  more  in  detail  hereafter,  we  content  our- 
selves with  barely  mentioning  in  this  place  the  prin- 
cipal remedies  for  it,  viz.,  Belladonna,  Spigelia, 
Arsenic,  Cannabis,  Bryonia. 

Rheumatic  as  well  as  catarrhal  fevers  may  exist 
simultaneously  with  other  acute  affections,  compli- 
cating them  and  making  the  use  of  other  remedies 
beside  those  here  mentioned  necessary ;  frequently, 
however,  one  of  the  above-mentioned  remedies  is  like- 
wise indicated  by  the  complication  of  the  symptoms.* 

*  An  interesting  remedy  for  rheumatic  fevers,  which  Hartmann  has  omit- 
ted to  mention,  is  Guajacum.  In  the  second  number  of  the  Examiner,  Vol. 
IV.,  we  have  recorded  a  most  remarkable  case  of  rheumatism  which  Dr. 
Schellhammer  cured  by  two  doses  of  Guajacum.  The  symptoms  were : 
violent  stitches  in  the  outer  side  of  the  right  calf,  which  soon  extended  as 
far  as  the  right  ankle  joint,  and  became  so  violent  that  the  patient  fell  down, 
and  was,  since  that  period,  no  longer  able  to  walk.  By  mismanagement,  the 
patient  was  reduced  to  the  brink  of  the  grave,  until  Schellhammer  effected 
a  complete  cure.  When  Schellhammer  was  called,  the  symptoms  were: 
violent  tearings  and  lancinations  in  the  whole  of  the  affected  side,  extorting 
constant  shrieks  day  and  night ;  cough,  with  expectoration  of  fetid  pus ; 
aversion  to  food;  nausea  and  vomiting  every  morning  ;  swelling  of  the  limb, 
it  was  drawn  up,  stiff  and  immoveable  ;  interstitial  distention  and  soften- 
ing of  the  tibia  and  tarsus;  hot  skin,  tongue  coated,  vehement  thirst. — 
HEMFEL. 


151 


FOURTH     CLASS. 

• 

GASTRIC    FEVERS. 

§  40.  The  fever  is  a  continuous  remittent,  the  diges- 
tive apparatus  being  principally  affected ;  the  fever 
differs  according  as  it  depends  upon  overloading  the 
stomach,  morbid  action  of  the  mucous  membrane  of 
the  stomach,  disturbed  secretion  of  bile,  or  derange- 
ment of  the  whole  intestinal  canal.  This  fever  is 
generally  ushered  in  by  premonitory  symptoms  which 
may  be  successfully  combated  by  homoeopathic  reme- 
dies, thus  preventing  the  fever  altogether.  The  fever 
commences  with  violent  heat,  restlessness,  oppression 
and  anxiety  ;  the  patient  feels  ill  and  weak,  complains 
of  violent  headache.  Frequently,  but  not  always, 
the  epigastric  region  is  sensitive,  especially  when 
touched,  and  the  following  symptoms  are  present : 
coated  tongue,  eructations,  disagreeable  taste,  vomit- 
urition  and  nausea,  increased  alvine  evacuations,  or 
else  constipation;  dark,  brown-red,  saffron-coloured 
urine,  sometimes  depositing  a  sediment,  want  of  appe- 
tite, increased  thirst. 

We  shall  offer  the  following  classification  of  those 
fevers,  which  has  no  reference  to.  the  seat,  course,  and 
terminations  of  the  disease,  for  these  are  frequently 
modified  by  epidemic  or  the  prevalent  morbid  influ- 
ences ;  nor  has  it  any  reference  to  the  intensity  of  the 
fever,  which  may  be  of  an  inflammatory  or  even 
typhoid  character. 

§  41.  Status  gastricus,  biliosus  et  pituitosus  ;  gastro- 
ataxia  saburralis,  oiliosa  et  pituitosa,  of  Schcenlein  ;  a 
gastric  condition  witliout  fever.  Premonitory  symptoms 
of  a  gastric,  bilious,  and  pituitous  fever. 

This  condition  is  characterized  by  the  following 
symptoms :  pressure  and  fulness  in  the  region  of  the 
stomach,  inclination  to  vomit,  constant  disagreeable 
eructations,  bitter  or  slimy  taste  in  the  mouth,  dryness 
of  the  mouth  or  confluence  of  saliva,  aversion  to  food, 
coated  tongue,  debility ;  weight  and  drawing,  or  else 
an  aching  pain  in  the  region  of  the  forehead ;  also,  in 


152  GASTRIC   FEVERS'. 

the  limbs,  altered  complexion,  restlessness,  low-spirit- 
edness, coldness  of  the  hands  and  feet.  All  these 
symptoms  are  distinct  indications  of  a  derangement 
of  the  digestive  functions. 

Persons  whose  digestive  powers  are  naturally  weak 
are  predisposed  to  such  a  state,  which  may  be  brought 
on  by  over-eating,  by  heavy  or  spoiled  food,  unwhole- 
some drinks,  bad,  damp  air,  great  heat,  anger,  chagrin, 
grief,  etc. 

It  is  not  difficult  to  treat  that  affection  homosopath- 
ically,  provided  the  exciting  cause  is  known.  The 
proper  and  timely  use  of  remedial  agents  shortens  the 
course  of  such  diseases,  and  prevents  their  running: 
into  corresponding  acute  affections. 

If  the  gastric  derangement  be  evidently  owing  to 
overloading  the  stomach,  the  best  medicine  is  fasting. 
The  patient  ought  to  content  himself  with  a  little 
water-gruel,  and  afterwards  take  some  black  co$ee. 

If  the  stomach  have  been  deranged  by  fat  meat  or  fat 
food  of  any  kind,  with  rancid  taste  and  eructations, 
the  patient  ought  to  fast  and  take  Pulsatilla ;  in  a  few- 
hours  he  will  feel  better,  especially  in  the  stomach. 

If  the  gastric  derangement  be  characterized  by 
eructations  tasting  of  the  ingesta,  by  nausea,  loath- 
ing, inclination  to  vomit,  Nature  is  frequently  compe- 
tent to  relieve  itself;  but  the  efforts  of  Nature,  which, 
if  unassisted,  are  frequently  unsuccessful  and  torment- 
ing, can  be  facilitated  by  tickling  the  velum  pendulum 
palati,  fauces  and  pharynx,  with  a  long  feather ;  if 
anything  should  remain  in  the  stomach,  a  little  black 
coffee  is  sufficient  to  carry  it  off  by  the  route  of  the 
intestines. 

If  the  stomach  should  have  been  overloaded  to  such 
an  extent  that  the  power,  or  even  the  inclination,  to 
throw  off  the  contents  spontaneously  should  have  been 
suppressed,  occasioning  great  pains  in  the  epigastric 
region,  the  dynamic  irritability  of  the  stomach  is 
restored  by  swallowing  a  spoonful  of  black  coffee  at 
successive  intervals,  after  which  the  contents  of  the 
stomach,  were  they  ever  so  excessive,  will  either  be 
thrown  off  by  the  mouth,  or  carried  off  by  the  rectum. 


GASTRIC     FEVERS.  153 

If  those  means  should  be  insufficient  to  remove  the 
contents  of  the  stomach,  or  if,  after  their  removal, 
loathing,  nausea,  inclination  to  vomit,  should  remain, 
these  symptoms  yield  to  Antimonium  crudum.* 

If  the  gastric  derangement  be  occasioned  by  some 
dynamic  cause,  violent  emotions,  etc.,  the  treatment 
differs.  If  any  of  the  above-mentioned  symptoms  of 
gastric  disturbance  arise  from  violent  chagrin,  a  small 
dose  of  Chamomilla  is  sufficient  to  remove  them.  If 
those  symptoms  and  the  still  continuing  chagrin  be 
accompanied  by  chilliness  and  coldness  of  the  body, 
Bryonia  alba  is  the  remedy. 

Gastric  disturbances  arising  from  violent  fright  and 
chagrin,  are  entirely  removed  by  Aconite  within  the 
space  of  three  or  four  hours. f 

Gastric  derangements  frequently  occur  in  persons 
who  are  constantly  bowed  down  by  grief  and  chagrin, 
other  morbid  symptoms  beside  those  of  the  gastric 
affection  being  likewise  present.  An  indispensable 
requisite  for  a  permanent  cure  is  the  removal  of  the 
causes  which  have  brought  on  the  disease.  The 
humane  physician  will  do  all  in  his  power  to  cheer  up 
the  patient,  and  to  afford  him  every  opportunity  for 
rational  amusement.  If  these  conditions  can  be  ful- 
filled, which  is  not  always  possible,  owing  to  the  limit- 
ed means  of  the  patient,  Ignatia  amara  will  be  found 
sufficient  to  remove  the  trouble  about  the  stomach  ;  if 
one  dose  should  not  be  sufficient,  another  one  may  be 
taken  in  two  hours,  either  weaker  or  of  the  same 
strength. 

If  the  gastric  symptoms  arise  from  taking  cold,  or 
from  exerting  the  mind  or  body  immediately  after  a 
meal,  were  it  even  moderate,  Nux  vomica  is  the  best 
remedy.  If  those  symptoms  owe  their  origin  to  cold- 
ness of  the  stomach,  occasioned  by  a  cold  drink  or 

*  Especially  if  there  remain  a  taste  of  the  food  in  the  mouth  ;  Nux 
vomica  is  in  many  cases  superior  to  Antimony.  The  spasmodic  vomiting  of 
mucus,  which  sometimes  remains  for  hours  after  the  contents  of  the  over- 
loaded stomach  have  been  thrown  off,  is  stopped  hy  Nux  vomica. — HEMPF.I.. 

t  The  most  prominent  symptom  of  a  gastric  derangement,  arising  from 
violent  chagrin,  is  sometimes  a  deep  sopor,  from  which  the  patient  can  only 
be  roused  by  shaking  him  violently  :  this  condition  yields  to  Opium  18. — 
HEMPEL. 

7* 


154  GASTRIC    FEVERS. 

fruit,  Arsenic  and  sometimes  Pulsatilla  are  the  best 
remedies  ;  a  gastric  derangement  which  is  character- 
ized by  a  good  deal  of  flatulence,  and  arises  from  eat- 
ing cabbage,  and  other  kinds  of  food  containing  watery 
particles,  yields  to  Bryonia. 

If  the  usual  symptoms  of  a  gastric  affection  be  ac- 
companied by  the  gulping  up  of  an  acrid  acidity  from 
the  stomach,  or  if  the  acidity  exist  without  the  other 
symptoms  as  a  chronic  affection,  which  is  usually 
termed  heartburn,  Nux  is  the  best  remedy,  provided  it 
corresponds  to  the  remaining  symptoms  ;  for  chronic 
heartburn,  Sulphuric  acid  is  perhaps  more  frequently 
suitable,  provided  all  the  accompanying  symptoms 
correspond. 

The  above-mentioned  symptoms,  denoting  a  disturb- 
ance of  the  gastric  functions,  may  all  be  brought  on 
by  the  fault  of  the  patient ;  but  they  may  also  occur 
as  a  sporadic  or  epidemic  disease  while  the  patient  is 
under  treatment  for  some  chronic  affection.  Under 
those  circumstances  the  above-mentioned  remedies 
have  to  be  employed,  but  in  as  weak  doses  as  possible, 
lest  the  treatment  of  the  principal  chronic  affection 
should  be  entirely  interrupted.* 

§  42.  Gastric  fevers ;  saburral,  gastric,  bilious  fever. 
We  have  alluded  to  the  precursory  symptoms   of 

*  There  are  other  symptoms,  and  also  other  remedies,  for  gastric  affections, 
which  Hartmann  has  not  mentioned.  We  recommend  Calcarea  carb.,  Carbo 
veg.,  China,  Capsicum,  for  acidity  of  the  stomach  and  heartburn,  each  6f 
those  remedies  to  be  chosen  in  accordance  with  the  symptoms. 

Carbo  animalis  is  an  excellent  remedy  for  sour  stomach,  with  scalding  sen- 
sation in  the  throat. 

Lycopodium  for  acid  risings  from  the  stomach,  constipation,  cuttings  from 
the  liver  to  the  epigastrium. 

Arsenic  for  bumings  in  the  pit  of  the  stomach,  oesophagus  and  pharynx, 
with  constrictive  or  suffocative  sensation  in  the  throat,  and  constant  thirst ; 
or  for  sensation  as  if  the  stomach  were  torn  to  pieces. 

Digitalis  for  excessive  debility  in  the  region  of  the  stomach  as  if  this 
would  die ;  accompanied  by  irregular  pulse. 

Ignatia  for  great  weakness  in  the  epigastric  region,  with  a  burning 
pricking. 

Spigelia  for  a  strange  sensation  of  weak  soreness  in  the  pit  of  the  stomach  ; 
the  patient  cannot  bear  the  pressure  of  the  clothes  ;  this  pain  is  frequently 
accompanied  with  soreness  of  one  eye-ball,  and  pain  on  turning  it  or  looking 
down ;  twitchings  in  the  lid,  sensitiveness  to  light. 

Lachesis  for  excessive  rolling  of  wind  from  the  stomach  upwards. 

Nux  vomica  for  gastric  derangement  arising  from  abuse  of  coffee  or  spiritu- 
ous drinks. 

Merc,  for  soreness  as  of  an  abscess  in  the  pit  of  the  stomach. — HEMPEI.. 


GASTRIC    FEVERS.  155 

those  fevers  in  the  preceding  paragraphs.  If  the  pre- 
cursory symptoms  be  not  relieved,  and  the  gastric  fever 
become  fully  developed,  then  the  fulness  and  pressure 
in  the  region  of  the  stomach  increase,  that  region  be- 
comes distended,  although  it  remains  soft  and  is  not 
sensitive  to  pressure  ;  it  is  filled  with  gas,  as  may  be 
ascertained  by  percussion,  accompanied  with  inclina- 
tion to  vomit,  rising  of  fetid  air,  sometimes  vomiting 
of  food  and  tenacious,  bile-coloured  mucus ;  the  tongue 
is  covered  with  a  thick  crust  of  dingy-yellow  mucus, 
the  abdomen  is  soft,  the  bowels  are  either  constipated 
or  else  the  patient  discharges  a  quantity  of  fetid  stool, 
consisting  of  badly-digested  food.  A  peculiar  kind  of 
headache  is  almost  always  present,  a  sort  of  pressure 
in  the  forehead,  commencing  in  the  frontal  sinus  and 
thence  spreading  over  the  orbital  region ;  general  feel- 
ing of  debility ;  wretched,  disfigured  appearance,  with 
yellow  tinge  of  the  whites  of  the  eyes ;  the  chilliness 
is  more  or  less  violent,  succeeded  by  heat  and  dryness 
of  the  skin ;  the  pulse  is  irritated,  quick,  soft,  some- 
times intermittent,  or  at  any  rate  unequal,  the  urine  is 
turbid,  smells  like  horse-urine. 

If  the  bilious  symptoms  be  particularly  prominent 
(in  \vhich  case  the  fever  is  called  febris  biliosa,  or  in 
the  language  of  the  older  physicians,  causus)  all  the 
symptoms  are  then  generally  more  violent,  the  heat  is 
very  great,  there  is  great  burning  and  turgescence  of 
the  skin,  the  restlessness  and  the  thirst  are  great,  the 
patient  has  a  great  desire  for  sour  drinks,  and  the 
prevalence  of  the  bilious  symptoms  is  visible  all  over. 
The  tongue  has  a  lemon-coloured  coating,  which  be- 
comes gradually  brown,  taste  and  eructations  are  bit- 
ter, the  patient  vomits  a  greenish,  bilious  matter,  the 
bowels  are  confined,  or  else  there  are  yellowish,  green 
or  brown  discharges  from  the  bowels,  the  countenance 
looks  livid,  and  somewhat  jaundiced  ;  these  symptoms 
are  sometimes  accompanied  by  sensitiveness,  hardness, 
tension,  warmth,  burning  in  the  region  of  the  liver  and 
stomach;  the  urine  is  dark-brown,  tinged  with  the 
colouring  matter  of  bile,  the  pulse  is  frequent,  full,  in- 
termittent or  double-beating. 


156  GASTRIC    FEVERS. 

§  43.  The  gastric  fever  is  liable  to  be  confounded 
with  typhus,  from  which  it  is  distinguished  by  the  ab- 
sence of  all  nervous  symptoms  (which  may  exist,  how- 
ever, when  the  fever  is  of  a  torpid  character),  and  of 
the  aching  pain  in  the  occiput ;  nor  are  the  senses  of 
sight  and  hearing  disturbed  with  illusions  ;  in  typhus 
the  region  of  the  stomach  is  not  distended,  but  is  pain- 
ful to  the  touch  ;  there  is  no  pain  in  the  region  of  the 
coBCum,  which  is  a  constant  characteristic  of  typhus; 
the  characteristic  typhus  evacuations  from  the  bowels 
are  likewise  wanting  in  gastric  fever,  nor  is  the  spleen 
^enlarged. 

Individuals  with  weak  stomachs,  suffering  with  dys- 
pepsia and  great  irritation  of  the  mucus  membrane  of 
the  stomach,  are  particularly  predisposed  to  gastric 
fever.  Cold  and  wet  weather  in  the  summer-season 
favours  the  occurrence  of  gastric  fevers,  which  are 
even  epidemic  at  such  periods  ;  they  may  be  likewise 
occasioned  by  injurious  and  heavy  food,  stimulating 
medicines  and  bitters,  overloading  the  stomach,  by 
chagrin,  anger,  cold  on  the  stomach.  Epidemic  bil- 
ious fever  is  sometimes  developed  out  of  an  epidemic 
fever  and  ague. 

The  course  of  the  disease  is  sometimes  very  rapid, 
twenty-four  or  seventy-two  hours,  sometimes  it  lasts 
fourteen  or  twenty-one  days.  A  successful  termina- 
tion of  the  disease  is  generally  accompanied  with  pro- 
fuse evacuations  of  some  kind,  either  vomiting  of  bad- 
ly tasting,  bilious  substances,  or  fetid  stools,  profuse 
sweats,  clear  urine,  with  earthy,  floeculent  sediment ; 
in  a  few  cases  miliary  eruption  makes  its  appearance 
upon  the  skin  in  the  region  of  the  abdomen  ;  an  erup- 
tion upon  the  lips  is  frequently  present.  The  fever 
may  leave  chronic  derangements  in  the  digestive  sys- 
tem, or  may  pass  into  typhus  or  intermittent  fever.  If 
the  so-called  typhoid  symptoms  supervene  during  the 
course  of  the  gastric  fever,  the  abdomen  becomes  dis- 
tended, meteorism  sets  in,  a  constant  sensation  of  pres- 
sure is  experienced  in  the  region  of  the  stomach,  there 
is  a  constant  inclination  to  vomit,  the  coating  of  the 
tongue  is  browner  than  usual,  the  tongue  is  dry,  the 


GASTRIC  FEVERS.  157 

extremities  are  cold,  the  pulse  is  frequent,  wiry,  small, 
the  urine  is  brown,  decomposed,  emitting  a  strong  am- 
moniacal  odour,  the  patient  becomes  delirious ;  invol- 
untary discharges  of  faeces  and  urine,  sopor,  and  the 
usual  typhoid  symptoms  set  in.  Death  rarely  takes 
place  by  local  disorganizations,  inflammation  and  ul- 
ceration  of  the  mucous  membrane  of  the  stomach ; 
death  is  more  frequent  by  the  gastric  fever  passing  in- 
to typhus,  and  paralysis  taking  place  in  consequence. 
Should  a  chronic  inflammation  and  subsequent  suppu- 
ration of  the  mucous  membrane  of  the  stomach  set  in, 
the  physician's  attention  will  necessarily  be  directed, 
by  the  obstinate  duration  of  the  gastric  symptoms,  to 
such  a  process  of  disorganization  having  commenced  ; 
and  he  will  find  that  the  fever,  which  gradually  in- 
creases again,  has  become  a  slow,  chronic,  secondary 
affection,  depending  upon  the  incipient  degeneration. 

In  most  cases  the  prognosis  is  favourable ;  the  com- 
plication with  typhoid  symptoms  makes  it  more  doubt- 
ful. The  convalescence  is  generally  very  short. 

§  44.  The  homoeopathic  treatment  of  simple  gastric 
fovers  is  generally  very  easy,  and,  in  most  cases,  suc- 
cessful. The  lighter  forms  of  those  fevers,  such  as 
saburral  fevers,  frequently  terminate  in  two  or  three 
days.  The  following  remedies  deserve  a  preference 
in  the  treatment  of  those  fevers :  Puls.,  Bryo.,  Nux 
vom.,  Ipec.,  Tart,  emet.,  Antim.  cr.,  Chamom.,  Coloc., 
Acid,  phosp.,  and  Arsenic. 

What  we  have  said  of  the  treatment  of  the  premon- 
itory gastric  state,  is  likewise  applicable  to  the  sim- 
plest kind  of  gastric  fever,  the  saburral  fever.  The 
same  remedies  will  generally  be  found  sufficient. 

Pulsatilla  is  a  specific  remedy  in  that  affection  when 
the  patient  is  out  of  humour  and  disposed  to  weep,  and 
when  the  following  symptoms  are  present :  great  chil- 
liness, absence  of  thirst,  aversion  to  food,  especially 
warm,  meat,  bread,  milk  and  tobacco  ;  slimy,  sour,  bit- 
ter, taste,  eructations,  vomiting  of  food,  pressure  at  the 
stomach,  and  sensation  as  if  the  food  were  in  the  in- 
testines undigested,  rumbling  in  the  abdomen,  nightly 
green  stools,  restless  night  sleep,  disturbed  with  dreams. 


158  GASTRIC    FEVERS. 

Pulsatilla  is  adapted  to  individuals  with  excessive  ve- 
nosity,  when  a  throbbing  is  experienced  in  the  pit  of 
the  stomach,  when  the  patient  is  periodically  affected 
with  stinging  pains  in  the  stomach,  and  the  fever  ex- 
acerbates in  the  forenoon.  Pulsatilla  is  likewise  suit- 
able in  that  form  of  gastric  fever,  which  was  desig- 
nated by  the  older  physicians  as  a  febris  gastrico-ve- 
nosa.  If  a  sense  of  illness,  debility,  a  chilliness  in  the 
body,  and  a  want  of  appetite,  should  remain  after  the 
exhibition  of  Antimonium  crudum,  these  symptoms  will 
yield  to  Pulsatilla ;  the  symptoms  remaining  after  An- 
timony may  likewise  indicate  Nux  or  some  other 
remedy. 

Nux  vomica  is  especially  suitable  to  irritable,  live- 
ly, plethoric  and  hypochondriac  individuals,  whose  di- 
gestive powers  have  been  weakened  by  mental  exer- 
tions, a  sedentary  mode  of  life,  abuse  of  coffee  and 
spirituous  drinks.  Nux  is  likewise  indicated  when  the 
gastric  fever  arose  from  a  violent  commotion  of  the 
mind  by  surprise,  fright,  quarrelling,  etc.,  and  the 
proper  specific  was  not  at  once  resorted  to,  allowing 
the  fever  time  to  establish  itself  in  the  system.  If  the 
gastric  disease  was  occasioned  by  frequent  chagrin, 
and  the  symptoms  occasioned  by  those  mental  disturb- 
ances do  not  yield  to  the  specific  remedy,  Nux  ought 
to  be  employed  (Pulsatilla  rivals  Nux  under  those  cir- 
cumstances). Nux  may  likewise  be  administered  for 
the  following  group  of  symptoms :  considerable  heat 
in  the  face,  burning  heat  in  the  eyes,  dry  lips,  great 
thirst,  violent  lancinating  pain  in  the  forehead  or  hemi- 
crania,  brownish  or  slimy  coating  of  the  tongue,  acid 
taste  in  the  mouth,  nausea,  tension  and  distention  of 
the  region  of  the  stomach  and  of  the  abdomen,  with 
fulness  and  pressing  towards  the  chest,  oppression  of 
breathing,  anxiety,  violent,  spasmodic  pains  in  the 
stomach,  with  sensation  of  griping  and  tearing  away, 
rumbling  and  pinching  in  the  abdomen,  constipation, 
flatulence,  yellowish  tinge  around  the  nose  and  mouth, 
general  restlessness,  great  sensitiveness  of  the  organs 
of  sense. 

If  there  should  be  an  excessive  tendency  of  the  vital 


GASTRIC   FEVERS.  159 

action  upward  and  downward,  with  vomiting  and 
diarrhoea,  cutting  pains  in  the  whole  of  the  abdomen, 
with  fetid  flatulence  and  discharges  of  undigested 
food,  Antimonium  crudum  is  the  best  remedy  even  in 
the  most  obstinate  and  dangerous  cases.  Ipecacuanha 
corresponds  more  to  a  gastric  derangement  brought  on 
by  general  causes,  such  as  :  weather,  etc.  (in  opposi- 
tion to  a  gastric  derangement  occasioned  by  specific 
influences,  such  as :  fat  food,  etc.),  when  inclination 
to  vomit  is  present,  or  \vhen  the  nerves  of  the  stomach 
are  excessively  sensitive  and  irritable,  and  the  intro- 
duction of  the  least  quantity  of  food  into  the  stomach 
brings  on  the  vomiting. 

Remedies  that  affect  the  healthy  organism  in  a 
similar  manner,  must  necessarily  correspond  to  similar 
morbid  conditions  ;  this  is  especially  the  case  with 
remedies  which  antidote  one  another.  It  is  for  this 
reason  that  Tartarus  emeticus,  which  antidotes  both 
Ipec.  and  Puls.,  is  a  useful  remedy  in  gastric  fevers. 
This  remedy  deserves  a  preference  when  the  following 
symptoms  make  their  appearance :  great  drowsiness 
with  the  fever ;  reddish,  itching  rash  on  the  trunk, 
especially  the  chest ;  violent  vomiting  and  nausea  day 
and  night,  yellow-brown  diarrhoeic  stools,  with  exces- 
sive cutting  in  the  bowels. 

Bryonia  is  a  distinguished  remedy  in  gastric  fevers, 
which  depend  upon  a  double  cause,  cold  and  chagrin. 
It  is  indicated  when  the  gastric  derangement  is  accom- 
panied by  great  febrile  heat,  mingled  with  slight  chills, 
great  debility,  nightly  exacerbation  of  the  symptoms, 
when  the  patient  is  irritable  and  out  of  humour,  and 
complains  of  a  pressing  pain  in  the  forehead  from 
within  outward.  These  symptoms  are  accompanied 
by  dry  mouth  and  tongue,  violent  thirst,  desire  for 
acidulated  drinks,  pressure  at  the  stomach,  stinging  in 
the  liver  when  touching  the  region  of  that  organ,  or 
when  coughing  and  taking  a  deep  inspiration  ;  empty 
retching,  continuing  for  some  time,  and  gradually  in- 
creasing to  a  bilious  vomiting  after  a  good  deal  of 
hickuping  (this  shows  that  Bryonia  is  a  good  remedy 
in  bilious  fevers),  accompanied  with  pinching,  cutting 


160  GASTRIC    FEVERS. 

colic,  constipation  being  sometimes  present.  Bryonia 
deserves  consideration  when  the  gastric  fever  is  com- 
plicated with  rheumatism,  and  when  the  synochal 
fever  threatens  to  assume  a  typhoid  character. 

Colocynth  is  on  a  par  with  Bryonia.  It  deserves  a 
preference  when  the  gastric  fever  was  brought  on  by 
a  fit  of  indignation,  by  deep  mortification  in  conse- 
quence of  humiliating  treatment,  and  when  it  is  ac- 
companied with  sleeplessness,  violent  heat,  with  a  hot, 
dry  skin,  and  a  full  accelerated  pulse.  The  colocynth 
fever  is  likewise  characterized  by  a  pressing  pain  in 
the  forehead,  which  is  more  violent  in  the  recumbent 
posture  than  in  walking.  The  gastric  symptoms  are 
not  as  intense  as  those  indicating  Bryonia.  If  vomit- 
ing be  present,  it  is  copious,  and  the  ingesta  are 
thrown  off;  the  colic  is  generally  very  violent,  is 
occasioned  by  eating  the  slightest  quantity  of  food, 
and  generally  consists  in  a  violent  cutting,  with  chil- 
liness and  tearing  in  the  lower  limbs,  and  frequent 
yellow-greenish  diarrhoaic  stools.  Colocynth  is  an 
excellent  remedy,  not  only  in  gastric,  but  also  in 
bilious  fevers. 

Acidum  phosphoricum  is  an  excellent  remedy  in 
such  fevers,  when  they  arise  from  grief,  deep  and 
gnawing  sorrow,  anxiety  and  care,  and  are  accompa- 
nied by  great  restlessness,  a  pushing  and  tumult  in  the 
blood,  and  profuse  sweats.  The  fever  generally  con- 
sists of  alternate  chilliness  and  heat,  strong,  irregular 
pulse,  and  extreme  apathy.  The  pressing  headache  is 
likewise  present,  but  more  in  the  vertex  than  in  the 
forehead,  and  is  accompanied  with  a  sensation  as  if 
the  brain  were  bruised.  The  whites  of  the  eyes  are  of 
a  dingy  yellow,  the  eyes  are  faint,  without  lustre, 
sunken,  surrounded  with  bluish  circles,  and  making  the 
face  look  pale  and  sunken.  The  thirst  is  greater  than 
the  appetite,  which  is  constantly  accompanied  with 
nausea ;  after  every  meal  the  patient  experiences  a 
painful  pressure  in  the  pit  of  the  stomach  which  is  in- 
creased by  contact.  Characteristic  indications  are 
the  burning  in  the  abdomen  with  sensation  as  if  it 
were  distended,  especially  in  the  umbilical  region, 


GASTRIC   FEVERS.  161 

and  the  discharges  by  the  rectum  of  white-grey 
mucus. 

One  of  the  principal  remedies  in  gastric  fevers,  and 
indeed  in  many  other  affections  of  the  mucous  mem- 
branes, is  Arsenic.  It  is  indicated  by  an  excessive 
prostration  of  strength  which  is  by  no  means  propor- 
tionate to  the  intensity  of  the  other  symptoms,  by  great 
dry  and  burning  heat,  and  panting  for  drink ;  a  number 
of  other  symptoms  which  do  not  generally  belong  to 
gastric  fevers  :  such  as  tearing,  buniing  pains  in  the 
extremities,  spasms,  pressing  headache,  loss  of  appe- 
tite, evanescent  sweats,  anguish,  etc.,  are  likewise 
present  and,  by  a  process  of  metaschematismus,  invade 
other  parts  and  internal  organs.  Arsenic  deserves 
especial  consideration  when  the  gastric  symptoms  are 
accompanied  with  violent  burning  pains  in  the  stomach 
and  pit  of  the  stomach,  swelling  and  pain  of  the  liver 
and  spleen,  meteorism. 

The  following  remedies  which  are  likewise  useful 
in  some  forms  of  gastric  fever,  will  be  spoken  of  more 
in  detail  in  the  subsequent  paragraphs :  Veratrum, 
Belladonna,  Cocculus,  Mercurius,  Staphysagria,  Digi- 
talis, China,  Taraxacum,  Asarum,  Ignatia,  Colchi- 
cum. 

§  45.  If  the  bilious  symptoms  be  the  most  promi- 
nent, Chamomilla  is  a  principal  remedy,  especially  if 
the  fever  originate  in  violent  chagrin  or  vehemence 
and  be  characterized  by  great  general  heat,  burning 
of  the  face  and  eyes,  violent  thirst,  bitter  bilious  taste 
in  the  mouth,  vomiting  of  a  substance  which  is  bitter 
as  bile,  thick,  yellow  coating  of  the  tongue,  tension  of 
the  abdomen,  and  the  hypochondria,  colicky  pains  in 
the  abdomen  accompanied  with  rumbling,  watery, 
green,  yellow  evacuations,  startings  as  if  in  affright, 
tossing  about  during  sleep,  sallow,  yellowish  com- 
plexion, excessive  irritability  and  sensibility  to  pain, 
painful  pressure  at  the  stomach  as  from  a  stone,  with 
shortness  of  breath  and  anguish.  Only  in  case  Cham- 
omilla should  have  been  used  as  a  tea  previous  to  the 
arrival  of  the  physician,  it  ought  not  to  be  administer- 


162  GASTRIC   FEVERS. 

ed  as  a  remedy.*  In  such  cases  CofFea,  Ignatia,  Nux, 
Cocculus,  Pulsatilla  are  better  indicated. 

Ignatia  is  preferable  to  Chamomile,  when  the  bilious 
fever  has  arisen  from  concealed  chagrin  and  when  the 
usual  Chamomilla  symptoms  are  moreover  accom- 
panied with  silent  grief  and  shame.  If  the  fever  wag 
occasioned  by  chagrin  with  indignation,  Staphysagria 
is  the  remedy.  Staphysagria  is  likewise  indicated 
when  the  disease  commenced  with  fainting  fits. 

Mercurius  deserves  especial  consideration,  when  the 
gastric-bilious  condition  is  accompanied  with  frequent 
diarrhceic  stools  of  green  mucus  which  is  sometimes 
acrid  and  streaked  with  blood,  the  discharges  being 
almost  always  preceded  by  a  painful  pressing  in  the 
rectum  and  an  anxious  tremor  with  colic  ;  the  patient 
is  moreover  affected  with  a  jaundiced  colour  of  the 
skin,  yellow-coated  tongue,  bitter  taste  and  eructa- 
tions, desire  for  sour  things,  great  sensitiveness  of  the 
region  of  the  liver  which  is  painful  and  distended,  the 
urine  is  dark  and  has  a  putrid  smell. 

China  deserves  consideration  in  cases  of  debility  oc- 
casioned by  the  use  of  cathartics  and  emetics,  (it  will 
therefore  have  to  be  frequently  employed  in  gastric 
fevers  which  had  been  treated  in  the  usual  old-school 
fashion)  and  when  the  following  group  of  symptoms 
occurs :  Dulness  and  want  of  clearness  in  the  head, 
vertigo  when  raising  the  body,  tearing  headache, 
especially  at  night ;  restless,  unrefreshing  sleep,  clay- 
coloured,  yellowish  tinge  of  the  skin,  and  whites  of 
the  eye  ;  yellow  coating  of  the  tongue,  dry  lips,  want 
of  appetite,  bitter  eructations  and  taste,  retching  and 
pressure  at  the  stomach,  oppression  of  the  chest, 
frequent  whitish  or  greenish-yellow  stools,  emission  of 
fetid  flatulence,  which  affords  no  relief;  dark  red 
urine,  slight  thirst,  great  debility,  disposition  to  be 
vehement  and  out  of  humour ;  enlargement,  and  indu- 
ration of  the  liver  and  spleen. 

*  As  a  general  rule  ;  but  there  are  cases  of  bilious  fever  or  bilious  colic 
where  Chamomile  tea  has  been  used  without  effect,  and  where  the  homoe- 
opathic preparation  of  that  drug  effected  a  cure.  Such  cases  have  occurred 
in  my  practice  at  any  rate. — HEMPEL. 


GASTRIC    FEVERS.  163 

If  the  gastric  and  bilious  symptoms  be  accompanied 
with  violent  cutting  pains  in  the  abdomen  which 
appear  at  intervals  and  seem  to  proceed  from  flatu- 
lence ;  if  there  be  an  entire  want  of  action  in  the 
rectum,  constipation  or  else  greenish-yellow  diarrhoea 
with  loud  rumbling  and  frequent  emission  of  flatu- 
lence ;  if  the  abdominal  pains  be  so  violent  that  the 
patient  is  on  the  point  of  losing  his  senses,  and  the 
body  becomes  cold ;  if  the  patient  have  an  anxious, 
irritable,  hypochondriac  mood :  Veratrum  album  is 
frequently  the  best  remedy. 

§  46.  We  sometimes  meet  a  peculiar  form  of  gastric 
fever,  which  was  formerly  termed  febris  venoso-gas- 
trica.  This  kind  of  fever  is  almost  always  preceded 
for  a  time,  often  even  for  years,  by  the  symptoms  of 
predominant  venosity  and  abdominal  plethora,  which 
is  easily  increased  by  an  error  in  diet,  or  by  other 
hurtful  influences,  and,  in  that  case,  gives  rise  to  febrile 
phenomena  and  to  derangements  in  the  digestive  and 
the  portal  system.  The  fever  is  obstinate  and  remit- 
ting, the  patient's  countenance  is  red  and  puffed,  he  is 
anxious,  out  of  humour,  melancholy,  the  bowels  are 
slow,  the  tongue  is  coated,  the  appetite  is  gone,  there 
is  nausea,  changed  taste,  without,  however,  any 
evidence  of  undigested  food  having  remained  in  the 
intestinal  canal,  the  pulse  is  mostly  hard,  small,  not 
frequent,  the  urine  is  either  not  altered  or  else  dark 
and  smells  like  horse  urine,  there  is  not  much  sweat, 
and  sometimes  the  sweat  is  cold.  After  the  fever  has 
lasted  about  a  fortnight,  the  patient  discharges  a  con- 
siderable quantity  of  fetid,  bilious,  or  slimy  substance ; 
these  discharges  relieve  the  patient  and  generally  break 
the  fever.  We  have  already  mentioned  that  Pulsatilla  is 
a  chief  remedy  in  such  fevers;  but  Digitalis  is  likewise 
recommended.  It  is  especially  suited  to  individuals 
with  sanguine  temperament  and  soft,  flabby  muscles, 
slow  pulse,  weak  stomach,  nausea,  bitter  mouth  in  the 
morning  on  waking,  vomiting  of  the  ingesta,  spasmodic 
griping,  tearing  pain  in  the  stomach,  sensitiveness  of 
the  pit  of  the  stomach  to  pressure,  vertigo,  aching  pain 
in  the  forehead  over  the  eyes,  great  debility  as  if  one 


164  GASTRIC    FEVERS. 

could  not  stand  upon  one's  feet,  little  sleep  and  anxiety. 
Among  the  other  remedies,  we  distinguish  Nux  vom., 
especially  when  the  small  of  the  back  is  weak;  and  a 
pain  as  if  bruised  is  experienced  in  that  region,  Verat. 
album,  Belladonna,  Bryonia,  Chamomilla,  Rhus  tox., 
Capsicum,  Arsenicum,  and  especially  Sulphur ;  this 
latter  remedy  is  a  specific  remedy  in  this  disease 
arising  from  chronic  abdominal  plethora,  which  is  fre- 
quently accompanied  by  haemorrhoidal  affections. 

Cocculus  and  Belladonna  deserve  a  particular  men- 
tion in  the  treatment  of  this  class  of  fevers.  Cocculus 
is  especially  adapted  to  gastric-bilious  fevers  which 
arise  among  other  causes  from  chagrin  and  abuse  of 
chamomile,  and  are  aggravated  after  every  eating  and 
drinking,  sleeping,  talking,  smoking,  coffee  ;  the  aggra- 
vation frequently  amounts  to  a  fainting  fit,  after  which 
great  debility  and  trembling  of  the  limbs  remain.  The 
fever  consists  principally  in  a  sudden,  pretty  violent 
flush,  with  thirst,  small,  hard  pulse,  cold  feet,  and  ex- 
cessive sensitiveness  of  feeling.  The  gastric  symptoms 
are  :  change  of  taste,  aversion  to  food  or  drink,  with 
heat  and  redness  of  the  face,  frequent  bitter  eructations 
followed  by  hickup,  oppression  at  the  stomach,  and 
pain  in  the  hypochondria  ;  constipation. 

Both  Cocculus  and  Bellad.  are  particulary  adapted 
in  such  fevers  to  children  and  females.  Belladonna  is 
particularly  useful  when  the  fever  occurs  after  a  cold, 
in  lymphatic  and  scrofulous  subjects.  The  fever  it- 
self is  a  violent  burning  heat,  with  strong,  quick  pulse, 
great  thirst,  profuse  dark  urine,  the  sleep  is  disturbed 
by  frightful  dreams ;  the  mind  is  agitated,  the  blood 
rushes  to  the  head,  which  aches  intensely,  the  cheeks 
are  hot  and  red.  These  symptoms  are  frequently 
accompanied  by  a  slimy  and  bilious  vomiting,  a  burn- 
ing, griping  tearing  in  the  umbilical  region,  and  fre- 
quent but  ineffectual  urging  for  stool. 

§  47.  In  robust  and  plethoric  young  individuals  the 
febrile  phenomena  are  sometimes  very  strongly  marked 
and  intense,  requiring  the  exhibition  of  Aconite,  which 
is  so  much  more  advisable  as  Aconite  has  proved  a 
specific  against  the  consequences  of  fright,  anger, 


MUCOUS    FEVERS.  165 

chagrin,  especially  when  the  circulation  and  the  func- 
tions of  the  liver  were  disturbed  by  those  causes. 
Aconite  is  particularly  indicated  by  violent  chills  fol- 
lowed by  a  general  dry  and  burning  heat,  hard,  full, 
bounding,  accelerated  pulse,  great  thirst,  and  a  general 
profuse  sweat  succeeding  after  the  heat. 

If  typhoid  symptoms  should  set  in,  or  if  the  fever 
should  become  a  real  typhus,  the  remedies  which  \vill  be 
more  particularly  described  in  the  chapter  on  typhus, 
such  as  Bryonia,  Belladonna,  Rhus  tox.,  Phosphorus, 
Arsenic,  etc.,  require  to  be  used.  Arsenic  is  suitable 
even  in  purely  gastric  fevers  when  the  following 
symptoms  are  present:  blackish,  diarrhoeic  stools, 
accompanied  with  violent  colic,  vomiting,  great  inter- 
nal burning  heat,  dry  lips  and  tongue,  unquenchable 
thirst,  excessive  debility  and  prostration,  great  anguish, 
nightly  restlessness,  burning  and  beating  in  all  the 
blood-vessels,  clammy  sweats,  apoplectic  symptoms. 

The  diet  requires  to  be  carefully  regulated,  of 
course.  However,  errors  in  diet  need  scarcely  to  be 
apprehended,  as  the  patients  have  an  aversion  to  food, 
especially  \varm  food.  The  best  beverage  is  fresh 
water,  in  a  very  few  cases  some  other  drink  may  be 
given. 

§  48.  Mucous  fevers,  erethism  of  the  mucous  mem- 
brane of  the  intestinal  canal. 

This  fever  is  essentially  a  catarrhal  affection  of  the 
greater  portion  of  the  mucous  membrane  of  the  chylo- 
poe'tic  canal ;  sometimes  the  mucous  membranes  of 
the  other  systems  and  organs  are  likewise  affected. 
The  precursory  symptoms  which  sometimes  set  in  a 
long  while  before  the  fever  breaks  out,  are :  loss  of 
appetite,  flat  taste  or  entire  absence  of  taste,  white 
slimy  coating  of  the  tongue,  loathing,  great  repletion 
of  the  stomach,  irregular  evacuations,  pale  counte- 
nance and  debility,  and  other  symptoms  which  have 
already  been  mentioned  among  the  precursory  symp- 
toms of  gastric  fever.  All  those  phenomena  are 
generally  mild,  sometimes  the  patient  feeling  rather 
comfortable,  chilly.  As  a  general  rule  the  develop- 


166  MUCOUS   FEVERS. 

ment  of  the  disease  takes  place  in  a  concealed  manner, 
the  symptoms  have  a  mild  character  and  the  disease 
is  on  that  account,  easily  neglected  and  overlooked. 
As  the  disease  proceeds,  the  patient  throws  up  a 
tasteless  white  mucus,  the  stomach  is  distended  by  the 
introduction  of  the  least  quantity  of  food,  a  tension 
and  pressure  being  experienced  at  the  same  time  ;  the 
tongue  which  had  been  so  far  covered  uniformly  with 
a  white  mucus,  now  becomes  dark-red  at  the  tip  and 
on  the  edges,  which  indicates  the  setting  in  of  a  ty- 
phoid condition.  On  the  other  hand  we  sometimes  see 
the  tongue  remain  \vhite  during  the  whole  course  of 
the  disease,  but  it  becomes  dry  especially  in  the  even- 
ing ;  the  taste  is  unpleasant,  with  sensation  as  if  the 
mouth  were  filled  with  mucus,  which  is  sometimes 
visible  and  lines  the  mouth  and  palate  like  glue  ;  in 
the  morning  long  threads  of  a  thick,  tenacious  mucus 
are  either  hawked  or  gagged  up.  The  bowels  are 
generally  slow  or  confined  ;  only  when  the  affection 
spreads  over  the  mucous  membrane  of  the  lesser  in- 
testines, the  patients  have  from  two  to  six  stools  a-day, 
accompanied  with  rumbling  and  pinching,  the  dis- 
charges consisting  in  white,  jelly-like  thready  mucus, 
mixed  with  undigested  food,  the  colouring  matter  of 
bile  and  pieces  of  worms  ;  the  urine  is  straw-coloured, 
loamy,  flocculent,  and  depositing  a  whitish  sediment. 
In  the  commencement  the  fever  has  distinct  remissions 
which  afterwards  become  almost  imperceptible,  the 
pulse  is  seldom  frequent,  rather  soft,  more  so  than  full 
and  irritated ;  thirst  and  sweat  are  moderate,  sometimes 
however  the  patient  has  a  great  desice  for  drink,  the 
skin  is  slightly  warm,  the  patient  feels  weak.  Drow- 
siness, aching  of  the  forehead,  restless  night  sleep,  dim 
eyes  without  lustre  are  almost  constantly  present,  the 
patient  is  generally  indifferent,  peevish,  in  a  state  of 
apathy. 

§  49.. The  mucous  fever  which  is  frequently  con- 
founded with  gastric  fever  and  typhus,  is  sufficiently 
characterized  by  the  peculiar  symptoms  of  the  mucous 
membranes  which  make  their  appearance  in  the  very 
commencement  of  the  disease,  by  the  copious  secretion 


MUCOUS    FEVERS.  167 

of  a  tenacious,  albuminous,  thready  mucus,  by  the 
coating  and  the  peculiar  colour  of  the  tongue,  by  the 
mildness  of  the  fever,  with  a  pulse  which  is  but 
slightly  or  not  at  all  accelerated,  and  by  the  absence 
of  pain  in  the  ileo-coscal  region,  of  the  characteristic 
typhus  evacuations  from  the  bowels,  of  enlargement 
of  the  spleen,  etc. 

Predisposing  causes  are  :  youthfulness,  female  sex, 
scrophulosis,  worm  affections,  disposition  to  chronic 
blennorrho3a  of  the  abdominal  organs,  especially  the 
stomach.  The  outbreak  of  the  disease  is  favoured  by 
wet  and  cold  or  damp  summer  weather,  and  by  con- 
fining one's  self  to  a  vegetable  diet,  consisting  princi- 
pally of  indigestible,  heavy  food ;  these  causes  are 
often  sufficient  to  make  the  fever  epidemic. 

The  course  of  the  disease  is  always  slow ;  in  the 
most  favourable  circumstances  it  lasts  a  fortnight, 
sometimes  much  longer,  as  the  patient  is  liable  to  re- 
lapses and  temporary  aggravations.  As  the  disease 
progresses,  the  symptoms  frequently  change  ;  some- 
times the  increased  secretion  of  mucus  spreads  over 
the  mucous  membrane  of  the  whole  abdomen,  the 
respiratory,  urinary,  and  genital  organs  ;  or  the  fever 
assumes  the  so-called  typhoid  character,  with  mutter- 
ing delirium,  humming  in  the  ears,  dull  and  stupid 
feeling  of  the  head,  hardness  of  hearing,  subsultus 
tendinum,  grasping  at  flocks.  Very  often  a  rash,  in 
the  shape  of  white  crystal-coloured  vesicles,  makes  its 
appearance,  accompanied  with  profuse,  fetid,  exhaust- 
ing sweats.  Sometimes  aphthae  form  in  the  mouth 
with  fetid,  cadaverous  smell  from  the  mouth,  and 
ptyalism ;  the  aphthae  may  even  affect  the  mucous 
membrane  of  the  whole  abdomen,  as  may  be  inferred 
from  the  existing  tenesmus  and  the  shreds  which  are 
discharged  from  the  rectum. 

The  disease  is  rarely  complicated  with  other  dis- 
eases ;  in  young,  plethoric  individuals,  however,  the 
mucous  membrane  may  become  inflamed  and  ulcer- 
ated. 

Post-mortem  examination  has  shown  the  following 


168  MUCOUS   FEVERS. 

results :  the  mucous  membrane  of  the  chylopoetic  canal 
is  covered  with  thick  viscid  mucus,  the  mucous  mem- 
brane itself  is  interstitially  distended,  of  a  dingy  grey 
colour,  reddish,  and  softened  to  such  an  extent  that  it 
can  be  pulled  off  or  even  wiped  off,  like  pap ;  the 
criptae  mucosae  are  enormously  enlarged,  distinctly 
visible  ;  some  parts  look  as  if  the  mucous  membrane 
had  been  cut  off,  without  redness,  swelling,  or  inter- 
stitial distention  about  the  edges. 

The  prognosis  is  not  unfavourable  even  when  the 
disease  is  perfectly  developed,  or  the  treatment  has 
been  neglected.  Slimy  diarrhoea,  supervention  of 
typhoid  or  putrid  conditions,  with  rash  and  aphthae, 
discharge  of  decayed  worms  make  the  prognosis  very 
doubtful.  Recovery  is  generally  characterized  by  the 
following  appearances :  mild  sweat  (a  rash  making 
its  appearance  which  afterwards  scales  off),  straw- 
coloured  urine,  with  a  thick  clayish  sediment,  and  calm 
sleep,  but  it  is  almost  always  slow,  and  the  patient  is 
greatly  inclined  to  have  relapses.  Death  either  takes 
place  by  the  formation  of  aphthae  covering  the  mucous 
membrane  of  the  abdominal  and  respiratory  organs 
and  becoming  gangrened,  or  in  consequence  of  the 
non-appearance  or  the  retrocession  of  the  rash,  or  by 
paralysis  of  the  abdominal  nerves  causing  meteorism, 
involuntary  discharges  of  cadaverous  stools,  small, 
weak  and  trembling  pulse,  and  sopor,  or  lastly  the 
brain  may  become  paralyzed. 

§  50.  It  is  of  great  importance  in  this  disease  to 
employ  suitable  remedies  before  the  fever  is  fully  de- 
veloped ;  this  will  frequently  enable  us  to  cure  the 
patient  in  a  very  short  time,  whereas,  if  the  precursory 
stage  be  neglected,  the  disease  becomes  very  obstinate. 
The  principal  remedies  for  the  precursory  symptoms 
of  mucous  fever  are :  Pulsatilla,  Ammonium  muriati- 
cum,  Nux  vomica,  Ipec.,  Merc.,  Dulc.,  Ignat.,  Staphys., 
Senega. 

Pulsatilla  deserves  a  preference  over  every  other 
remedy  in  individuals  of  a  flaccid,  lax,  venous-lym- 
phatic constitution,  who,  by  eating  too  much  fat  and 


MUCOUS    FEVERS.  169 

rich  food,  have  brought  on  a  total  want  of  appetite, 
flat,  slimy  taste,  coated  tongue,  chilliness,  ill  humour, 
and  a  want  of  muscular  tonicity. 

The  physiological  effects  of  Ammonium  correspond 
perfectly  to  the  symptoms  of  the  status  pituitosus.  For 
centuries  past  Ammonium  has  been  recommended  for 
those  morbid  phenomena  which  it  produces  in  the 
healthy  organism  in  the  most  striking  manner.  White 
slimy  coating  of  the  tongue,  constant  hawking,  occa- 
sioned by  a  quantity  of  viscid  mucus  in  the  throat ;  a 
disagreeable,  pappy  taste  in  the  mouth,  with  con- 
fluence of  water,  aversion  to  food,  loathing,  empty 
eructations,  gulping  up  of  bitter,  sour  water,  malaise 
and  warmth  in  the  stomach,  discharge  of  glassy, 
tenacious  mucus  by  the  rectum,  etc.,  indicate  the  use 
of  Ammonium. 

Nux  vomica  is  suitable  when  the  patient  has  been 
irritated  by  chagrin,  and  when  the  following  symptoms 
occur :  dry  tongue,  coated  with  white  mucus,  disposi- 
tion to  acidity  of  stomach,  dyspeptic  symptoms  after 
every  meal,  heartburn,  distention  of  the  pit  of  the 
stomach,  constipation,  dull  and  obtuse  feeling  about 
the  head.  Dulcamara  is  recommended  when  the  fever 
has  heen  occasioned  by  a  cold,  and  when  it  is  charac- 
terized by  the  following  group  of  symptoms  :  flat,  soap- 
like  taste,  great  thirst,  dryness  of  the  tongue,  increased 
secretion  of  saliva,  aversion  to  any  kind  of  food,  dingy 
white  coating  of  the  tongue. 

Another  distinguished  remedy  is  Mercurius,  which 
corresponds  both  to  the  precursory  symptoms  and  to 
the  disease  itself,  when  it  has  reached  a  certain  de- 
gree of  development.  Mercurius  is  indicated  by  the 
following  symptoms :  increasing  diminution  of  appe- 
tite, tongue  coated  with  white  mucus,  excessive  and 
painful  dryness  in  the  throat  when  swallowing,  putrid 
taste  and  smell,  loathing  and  nausea,  tearing  burning 
pains  in  the  temples,  pressure  and  tension  in  the  pit  of 
the  stomach,  in  the  region  of  the  stomach  and  liver, 
regurgitation  of  an  acrid  fluid  into  the  mouth,  turbid, 
slimy  urine  depositing  a  sediment,  irregular  evacua- 
tions, with  frequent  tenesmus,  pale,  livid,  yellowish 
8 


170  MUCOUS    FEVERS, 

countenance,  debility,  want  of  irritability ;  character- 
istic symptoms  are :  thick  coating  of  a  dirty  mucus  on 
ths  tongue,  flat,  pappy  taste  as  of  soap,  great  desire 
for  piquant  dishes,  dryness  of  the  mouth  and  throat, 
sluggish  stools  or  else  constipation,  or  diarrho&ic  stools 
of  fetid  mucus,  great  mental  and  physical  prostration. 

In  the  commencement  of  the  disease,  Ignatia  is 
sometimes  useful,  especially  when  the  symptoms  are 
changeable,  and  when  the  following  group  of  symp- 
toms occurs :  great  indolence,  inclination  to  lie  down, 
weight  and  pressure  in  the  forehead,  pain  in  the  pit  of 
the  stomach,  alternate  redness  and  paleness  of  the 
face,  dry  and  chapped  lips,  white-coated  tongue,  flat, 
insipid  taste,  great  aversion  to  food  and  drinks,  re- 
gurgitation  of  a  bitter  substance,  frequent  discharges 
of  white  mucus  ;  sudden  flushes  of  heat  over  the 
whole  body  are  frequently  present,  with  small,  acceler- 
ated pulse. 

Staphysagria  may  likewise  prove  useful  in  the  first 
commencement  of  the  disease,  and  competes  with 
Ignatia  when  the  disease  has  been  occasioned  by 
moral  emotions.  But  even  in  the  highest  degrees  of 
pituitous  fevers,  Staphysagria  is  an  excellent  remedy, 
even  when  typhoid  and  putrid  symptoms  have  made 
their  appearance.  The  attending  physician  will  easily 
discover  the  symptoms  indicating  Staphysagria  with- 
out our  mentioning  them.  All  that  we  intended  to  do 
was  to  point  to  Staphysagria,  and  likewise  to  Senega, 
which  is  indicated  for  many  affections  of  the  mucous 
membranes,  especially  when  the  patients  are  of  a 
phlegmatic,  passive  disposition.  In  cases  where 
Senega  is  indicated  the  fever  is  not  very  violent,  there 
are  merely  slight  shiverings  and  heat,  accompanied  by 
a  beating  pain  in  the  head,  laboured  breathing  with 
anxiety,  stitches  in  the  chest,  the  whole  body  feels 
bruised,  the  pulse  is  Jrequent,  and  the  thirst  increased  ; 
the  stools  are  rather  less  frequent,  in  a  few  cases  more 
frequent  than  usual ;  there  is  an  accumulation  of 
viscid  mucus  in  the  throat,  occasioning  constant  hawk- 
ing. 

The  following  remedies  have  likewise  been  found 


MUCOUS    FEVERS.  171 

useful  in  practice :  Bryo.,  Rheum,  Cham.,  Dig.,  Anti- 
monium  cr.  and  Tart,  emet.,  Cina,  Bellad,  Ac.  sulphur., 
Ars.,  Phosph.,  Sepia,  China,  Rhus,  Spig.,  Mezereum. 
Digitalis  especially  is  a  distinguished  remedy  in  fully- 
developed  mucous  fevers  when  the  vital  forces  are 
greatly  depressed,  when  the  pulse  is  slow,  the  patient 
is  very  feeble,  complains  of  pressure  and  fulness  in  the 
pit  of  the  stomach,  constant  loathing,  nausea  and  fre- 
quent vomiting,  thirst,  diarrhoea,  vertigo,  aching  in  the 
forehead  over  the  eyes,  restlessness,  and  scarcely  any 
sleep. 

Sepia  may  likewise  be  ranked  among  the  remedies 
for  pituitous  fever  ;  it  is  frequently  adapted  to  fevers 
of  that  kind  which  have  a  long  run  without  being 
characterized  by  any  violent  symptoms.  We  take 
this  opportunity  of  remarking  that  Sepia  is  an  excel- 
lent remedy  for  plethora  venosa  abdominalis,  provided 
the  symptoms  correspond. 

If  the  fever  assume  a  torpid  character  and  typhoid 
symptoms  make  their  appearance,  Bryonia  will  be 
found  an  excellent  remedy  as  long  as  the  typhoid 
symptoms  have  not  reached  a  high  degree  of  violence 
and  when  the  following  group  of  symptoms  occurs : 
violent  congestion  to  the  head,  dry,  burning  heat,  dry 
lips,  dry,  red  tongue,  pressure  at  the  pit  of  the 
stomach,  constipation,  wandering  looks,  slight  delirium, 
etc.  Rhus  corresponds  to  similar  symptoms  when  the 
pulse  is  very  much  depressed.  Belladonna  deserves  a 
preference  when  the  brain  is  principally  affected  and 
when  the  following  symptoms  occur :  quick,  hard 
pulse,  dry  skin,  great  thirst,  parched  tongue.  If  the 
increased  secretion  of  mucus  spread  over  the  respira- 
tory organs  and  the  intestinal  canal,  if  expectoration 
of  mucus,  rattling  in  the  trachea  and  diarrhoea  be  pre- 
sent, if  the  patient  lie  still  with  open  mouth,  dry, 
parched,  black  lips  and  tongue,  if  the  respiration  be 
oppressed  and  delirium  and  floccilegium  be  present, 
Phosphorus  is  the  suitable  remedy.  If  rash  threaten 
to  break  out,  which  is  almost  always  accompanied 
with  a  peculiar  sighing  breathing,  Ipecacuanha  is 
particularly  suitable.  If  the  rash  should  have  actually 


172  WORM   FEVER. 

broken  out,  or  should  have  receded,  Arsenic  may  still 
save  the  patient's  life.  The  characteristic  symptoms 
in  such  a  case  are :  sopor,  cold  sweats,  blackish  lips 
and  teeth,  dry,  trembling  tongue,  unquenchable  thirst, 
meteorism,  involuntary  discharges  of  faeces  and  urine, 
snoring,  oppressed,  and  excessively  hurried  breathing, 
small,  trembling,  very  frequent  pulse,  automatic  move- 
ments of  the  hands,  nightly  muttering  delirium.  (Aci- 
dum  phosp.,  and  Carbo  veg.  ought  to  be  thought  of 
when  those  symptoms  occur).  Arsenic  is  likewise  in- 
dicated when  aphthae  form  in  the  mouth,  no  matter 
whether  it  be  a  simple  or  putrid  ulceration,  and  affect 
the  whole  intestinal  canal.  For  simple  aphthous  ulcer- 
ation Mezereum  may  likewise  be  indicated,  especially 
when  a  violent  burning  in  the  fauces  and  stomach  is 
present,  and  the  aphthae  look  flat  and  flaccid ;  Mer- 
curius,  Acid.  nitr.  and  sulp.  may  also  prove  curative. 
If  gangrene  threaten  to  set  in,  Arsenic  is  the  first 
remedy,  China,  Ac.  mur.,  Carbo  veg.  and  Baryta  are 
the  principal  remedies  next  to  Arsenic. 

The  diet  is  of  the  utmost  importance  both  in  the  pre- 
cursory stage,  in  order  to  prevent  the  full  development 
of  the  fever,  and  in  the  stage  of  convalescence,  in  order 
to  prevent  a  relapse.  The  object  of  diet  in  the  pre- 
cursory stage  is  to  arrest  the  excessive  secretion  of 
mucus ;  in  the  stage  of  convalescence  the  object  of 
diet  is  to  invigorate  the  patient  by  suitable  nourish- 
ment without  exposing  him  to  the  danger  of  having  a 
relapse  for  which  there  is  a  great  disposition.  The 
patient  ought  to  take  small  quantities  of  liquid  food 
with  a  good  deal  of  drink,  the  convalescent  patient 
may  add  a  few  drops  of  wine  to  his  drink. 

§  51.   Worm  fever;   helminthiasis. 

Worm  affections,  with  or  without  fever,  are  evi- 
dently chronic  diseases.  Entozoa  are  no  disease, 
but  the  product  of  disease,  which  may  however  react 
upon  the  organism  as  a  morbific  cause.  We  class 
worm  fever  and  even  the  chronic  condition  which  is 
termed  helminthiasis,  among  the  acute  diseases  for 
this  reason,  that  a  worm  fever  is  very  similar  to  gas- 


WORM    FEVER.  173 

trie  and  pituitous  fevers,  and  that  it  generally  sets  in 
only  while  the  organism  is  under  the  influence  of  some 
other  affection  which  makes  the  contents  of  the 
bowels  unpleasant  to  the  worms  ;  \vhen  this  is  the 
case,  the  worms  writhe  and  twist  themselves  about  in 
the  intestines,  irritating  the  mucous  membrane  of  these 
organs. 

Physicians  have  mentioned  so  many  symptoms  as 
indicating  the  presence  of  worms  that  it  is  difficult  to 
offer  a  well-marked  image  of  a  worm  fever.  Many  of 
those  symptoms  are  extremely  changeable  ;  they  are 
occasioned  by  the  temperament,  sex,  individuality,  or 
mode  of  life  of  the  patient,  or  may  characterize  the 
gastric,  pituitous,  or  other  similar  affections  of  the 
patient.  Nevertheless  there  is  a  sufficient  number  of 
characteristic  symptoms  which  leave  no  doubt  about 
the  true  nature  of  the  affection ;  these  are  the  pheno- 
mena which  reveal  the  characteristic  irritation  of  the 
mucous  membrane  of  the  intestines.  But  even  of  these 
symptoms,  no  single  symptom  has  any  decisive  value 
as  a  diagnostic  symptom ;  it  is  the  simultaneous  oc- 
currence of  a  number  of  such  symptoms  which  decides 
the  character  of  the  disease.  The  discharge  of  one  or 
more  worms  or  pieces  of  worms  is  no  certain  proof 
that  the  existing  fever  is  occasioned  by  those  animals, 
since  it  is  a  well-known  fact  that  worms  may  even 
exist  in  the  h/eralthy  body,  and  probably  do  exist  more 
or  less  in  &very  child.  The  following  are  the  more 
permanent  symptoms  of  a  worm  disease :  pains  in  the 
abdomen,  almost  always  proceeding  from  the  umbilical 
region,  and  being  frequently  a  mere  sensation  of  pres- 
sure or  constriction,  which  is  sometimes  very  violent, 
amounting  to  colic  ;  if  the  affection  arise  from  asca- 
rides,  the  pain  is  generally  local,  accompanied  with  the 
following  symptoms  :  troublesome  itching  of  the  anus, 
especially  in  the  evening,  dysuria,  stranguria,  tenes- 
mus,  apparent  haBmorrhoidal  sufferings,  discharge  of 
mucus  by  the  rectum,  bladder,  vagina  ;  uncommon 
periodic  sadness,  gloominess,  and  irritability  of  temper ; 
when  tsenia  is  present,  the  patient  frequently  experi- 
ences a  sensation  as  if  something  were  crawling  or 


174  WORM    FEVER. 

twisting  itself  from  the  left  side  of  the  abdomen  to- 
wards the  stomach  and  even  the  oesophagus ;  or  a 
sensation  as  of  the  undulating  movement  of  a  cool 
ball  in  one  or  the  other  side,  sensation  as  if  something 
were  sucking  in  the  abdomen,  vertigo,  tingling  and 
numb  sensation  in  the  fingers  and  toes,  they-  are  dis- 
posed to  go  to  sleep  ;  the  pain  is  always  periodical,  not 
continuous,  it  occurs  principally  in  the  morning  and 
when  fasting,  and  is  generally  relieved  by  eating ;  the 
quality  of  the  food  influences  the  pain  greatly :  it  is 
increased  by  milk,  sugar,  and  other  sweet  things,  by 
acrid  and  salt  food,  ham,  cheese,  and  by  the  so-called 
anthelmintica.  The  abdomen  is  not  painful  when 
pressed  upon,  it  is  soft,  sometimes  distended,  the  taste 
in  the  mouth  is  unpleasant,  the  smell  from  the  mouth 
is  offensive,  the  appetite  is  irregular,  now  canine  hun- 
ger, and  then  again  aversion  to  food  ;  the  tongue  is 
frequently  coated  white,  and  the  mouth  is  filled  with 
water.  The  bowels  are  at  times  confined,  at  times 
there  are  loose  and  slimy  stools.  If  the  worms  be 
lodged  in  the  duodenum  and  stomach,  there  is  pressure 
and  a  gnawing  pain  in  the  pit  of  the  stomach,  eructa- 
tion, vomiting,  sometimes  even  vomiting  of  worms. 
Other  symptoms  are  :  itching,  tingling,  and  bleeding  of 
the  nose,  frequent  sneezing;  pale  countenance,  sunken 
eyes  surrounded  with  blue  margins,  squinting,  dilated 
pupils ;  restless  sleep,  during  which  the  patient  starts 
frequently ;  ruminating,  grating  of  the  teeth,  talking  in 
sleep ;  indolence ;  emaciation  of  the  extremities ; 
bloatedness  of  the  countenance.  The  febrile  erethism 
is  characterized  by  a  little  chilliness,  a  small,  irregular, 
and  even  intermittent  pulse,  clammy  sweat,  turbid 
urine,  smelling  like  horse  urine.  The  febrile  pheno- 
mena, as  a  general  rule,  are  vague  and  uncertain, 
sometimes  they  are  very  violent,  the  heat  being  very 
great  and  accompanied  with  sopor,  shrieking  and 
trembling.  Less  permanent  symptoms  are :  jactitation 
of  the  muscles,  spasms,  vertigo,  fainting  turns,  illusions 
of  sight  and  hearing,  oppression  of  the  chest,  palpita- 
tion of  the  heart,  hickup,  paralysis,  stupor,  sopor, 
cerebral  diseases,  hemorrhage,  blennorrhoea,  ischury, 


WORM    FEVER.  175 

strangury.  Worm  affections  almost  always  increase 
and  decrease  with  the  moon;  when  the  moon  is  on  the 
decline,  a  quantity  of  worms  is  frequently  passed. 

§  52.  The  formation  of  worms  occurs  most  frequently 
in  childhood.  Sometimes  the  worms  are  hereditary 
(they  have  even  been  found  in  the  foetus) ;  they  occur 
rarely  in  infants  at  the  breast,  most  frequently  in  the 
period  of  dentition,  very  rarely  in  the  age  of  adoles- 
cence (except  taenia,  which  is  most  frequent  at  that 
age),  and  rather  more  frequently  in  the  declining  age ; 
they  are  more  apt  to  be  found  in  females,  and  in  per- 
sons of  a  leuco-phlegmatic  constitution,  with  disposi- 
tion to  excessive  formation  of  mucus  and  blennorrhosa. 
Exciting  causes  are  :  bad  food,  vegetable  diet  in  pref- 
erence to  meat,  uncleanliness,  and  a  damp,  tepid  at- 
mosphere, which  may  convert  helminthiasis  into  an 
endemic  or  epidemic  disease. 

Helminthiasis  may  easily  be  confounded  with  hy- 
drocephalus,  especially  when  the  so-called  nervous 
symptoms,  sopor,  spasms,  dilated  pupils,  vomiting,  are 
present ;  but  in  helminthiasis  the  abdomen  is  soft  and 
distended,  whereas  in  hydrocephalus  it  is  flat  and 
drawn  in ;  in  hydrocephalus  the  head  feels  hot  to  the 
touch,  and  the  symptoms  occur  in  a  certain  succes- 
sion, whereas  in  helminthiasis  the  symptoms  are 
changeable,  and  occur  at  uncertain  periods. 

Worm  diseases  have  a  slow  run,  and  are  very  much 
disposed  to  occur  again,  or  the  patient  is  apt  to  have 
a  relapse.  Other  diseases,  such  as  chronic  inflamma- 
tion of  the  mucous  membrane  of  the  intestines,  result- 
ing in  perforation,  mucous  fevers,  epilepsy,  hectic  fever 
(occasioned  by  the  disordered  process  of  nutrition), 
may  arise  from  worm  affections. 

The  prognosis  is  favourable  ;  it  is  most  favourable 
in  diseases  arising  from  ascarides,  least  favourable  in 
taenia  on  account  of  the  symptoms  being  more  obsti- 
nate and  the  cure  more  uncertain.  If  the  worms  be 
lodged  in  the  large  intestine,  the  cure  is  always  more 
easily  accomplished  than  when  the  worms  are  lodged 
in  the  lesser  intestines  or  the  stomach. 

§  53.  The  surest  way  to  cure  worm  diseases,  is  to 


176  WORM   FEVER. 

remove  that  morbid  condition  of  the  digestive  organs 
which  always  precedes  and  favours  the  formation  of 
worms.  According  to  Hahnemann's  view  it  is  not  re- 
quired to  remove  the  worms,  inasmuch  as  they  result 
from  a  general  constitutional  illness,  and  an  unwhole- 
some mode  of  life  ;  if  the  constitutional  disturbance, 
which  has  generally  a  psoric  origin,  be  cured  homoeo- 
pathically  (which  can  be  done  easily  in  childhood), 
few  or  none  of  the  worms  will  remain,  or,  at  any  rate, 
the  children  will  not  he  troubled  by  them,  whereas 
the  worms  are  reproduced  in  quantities  after  the 
bowels  have  been  purged  with  cathartic  medicines, 
even  when  mixed  with  Cina.  However,  not  to  men- 
tion the  circumstance  that  the  organism  is  in  a  more 
or  less  anormal  condition  as  long  as  worms  are  pre- 
sent, even  if  there  should  be  an  appearance  of  health, 
it  is  certainly  true  that  the  entire  removal  of  the 
worms,  either  living  or  dead,  is  most  desirable,  and  is, 
in  some  respects,  the  chief  object  of  the  treatment,  in- 
asmuch as  it  is  the  most  certain  proof  that  the  reme- 
dies have  effected  a  cure.  As  long  as  no  troublesome 
or  dangerous  symptoms  make  their  appearance  medi- 
cal aid  is  seldom  resorted  to  against  worms,  nor  is  it 
required.  We  know  very  well  that  lumbrici  and  as- 
carides  may  live  on  the  contents  of  the  bowels  of 
children  without  irritating  these  organs  in  the  least. 
Worms,  taenia  excepted,  require  medical  treatment  so 
much  less,  as  they  exist  only  for  a  limited  number  of 
years  in  the  organism  ;  after  that  period  the  worms 
disappear  of  themselves,  owing  to  the  changes  which 
take  place  in  those  vital  secretions  upon  which  the 
existence  of  the  worms  depended.  At  any  rate  a  pal- 
liative treatment  will  be  sufficient  in  such  cases  to  ef- 
fect  a  cure.  We  ought  to  observe,  that  notwithstand- 
ing the  considerable  number  of  remedies  which  we 
possess  in  our  practice  for  curing  worm  affections,  in 
v.  hich  we  succeed  in  most  cases,  there  exist  no  specific 
r*  medies,  and,  indeed,  there  cannot  exist  any  for  the 
ifr  mediate  removal  of  the  worms  ;  if  this  be  desired 
v.  e  have  to  resort  to  large  doses  of  the  so-called  an- 
thelmintica.  This,  however,  is  entirely  unnecessary ; 


WORM    FEVER.  177 

for  we  know  for  certain  that  the  small  homosopathic 
doses  of  a  properly-selected  remedy  are  entirely  suffi- 
cient to  destroy  the  worms,  which  are  afterwards  car- 
ried off  by  the  rectum. 

The  following  are  the  general  remedies  against 
worm  diseases  :  Aconite,  Bell.,  Cina,  China,  Dig.,  Fer- 
rum,  Asar.,  Calc.  c.,  Graph.,  Ignat.,  Marum  verum, 
Merc.,  Nux  v.,  Filix  mas,  Sabad.,  Spigel.,  Stram., 
Stann.,  Silic.,  Valer.,  Verat.,  Sulphur,  and  others. 

If  the  symptoms  arise  from  the  presence  of  ascarides 
in  the  colon  and  rectum  (they  are  scarcely  ever  found 
in  any  other  part),  Aeon.,  Ferr.,  Ignat.,  Merc.,  Nux  v., 
and  Valeriana  are  the  best  remedies.  Against  the  in- 
tolerable itching  and  the  feeling  of  excoriation  and 
soreness,  Ignatia,  Tinct.  sulph.,  and  Marum  verum  are 
especially  useful ;  Mercurius  is  indicated  for  the  violent 
diarrhoea  and  tenesmus ;  Ferrum  for  the  vomiting 
and  the  confluence  of  water  in  the  mouth,  Valeri- 
ana for  the  nightly  itching  and  the  muscular  spasms 
and  sleeplessness  arising  from  it. 

The  morbid  phenomena  denoting  the  presence  of 
lumbrici,  generally  correspond  to  Nux  v.,  China,  Cina, 
Bellad.,  Merc.,  Spigelia.  Nux  v.  is  especially  useful 
against  great  distention  and  sensitiveness  of  the  ab- 
domen and  the  region  of  the  stomach,  heat  in  that 
region,  hard  stool,  inclination  to  vomit,  excessive 
general  irritability  and  sensibility,  aggravation  of  the 
symptoms  early  in  the  morning. 

China  is  indicated  when  the  symptoms  are  aggra- 
vated principally  at  night,  when  after  every  meal  the 
patient  experiences  a  painful  pressure  below  the  um- 
bilicus, fulness  of  the  abdomen,  heartburn  with  con- 
fluence of  water  in  the  mouth,  cardialgia  and  retching ; 
when  the  nervous  system  is  excessively  sensitive,  with 
spasmodic  jactitation  of  the  muscles  in  various  parts, 
tremor  and  debility  (Valer.  may  prove  useful  when 
those  symptoms  occur). 

Cina  is  a  principal  specific  against  worm  affections 

of  children,  when  arising  from  the  presence  of  oxyurides 

vermiculares  and  ascarides  lumbricoides,  and  when 

the   group   of  symptoms   is   constituted   as   follows : 

8* 


178  WORM    FEVER. 

evening  chilliness,  small,  rather  hard,  frequent  pulse, 
little  sleep,  tossing  about,  shrieking  and  starting  in 
sleep,  ill  humour,  imbecility,  transitory  paroxysms  of 
delirium,  weight  in  the  limbs,  alternate  paleness  and 
coldness,  and  then  again  redness  and  heat  of  the  face, 
dilatation  of  the  pupils,  continual  rubbing  of  the  tip  of 
the  nose,  stoppage  of  the  nose,  lying  on  the  back  with 
open  mouth,  coating  of  tenacious  mucus  on  the  tongue, 
offensive  eructations,  vomiting,  hot,  distended  abdo- 
men, colic,  difficulty  of  evacuating  the  bowels,  and 
costiveness,  itching  of  the  anus,  the  ascarides  crawl 
out  at  the  anus,  the  urine,  which  is  emitted  involunta- 
rily, is  white,  turbid,  cloudv,  (compare  Ignatia  and 
Grap.) 

Belladonna  is  most  suitable  when  the  cerebral 
functions  are  disturbed,  and  when  the  following  symp- 
toms prevail :  somnolency,  spasms,  illusions  of  the 
senses,  great  thirst,  starting  during  sleep  as  if  in 
affright,  paralysis  of  the  anus  with  involuntary  dis- 
charge of  faeces  and  urine,  retention  of  urine. 

Spigelia  corresponds  to  those  symptoms  which  are 
especially  violent  after  dinner,  when  the  patient  com- 
plains of  pinching  pains  in  the  abdomen,  with  coldness 
and  diarrhoea,  canine  hunger  and  thirst,  morning 
nausea  with  sensation  as  if  something  were  crawling 
out  of  the  stomach  into  the  throat,  biting  in  the  nose, 
pale  countenance,  palpitation  of  the  heart,  anguish. 

If  convulsions  should  set  in,  Cham.,  Ignat.,  Stram., 
Hyosc.,  will  prove  useful  next  to  Belladonna  ;  if  there 
should  be  a  violent  vascular  erethism,  Aconite  may 
be  given  before  any  other  remedy.  If  the  cutting 
pains  in  the  abdomen  should  be  accompanied  with 
partial  spasms  of  the  abdominal  muscles,  and  painful 
ineffectual  pressing  upon  the  rectum,  Stramonium  is 
recommended  ;  Cicuta  virosa  is  indicated  for  a  febrile 
condition,  with  violent  colic  and  convulsions.  If  the 
symptoms  which  characterize  the  worm  affection,  be 
worms  discharged  or  not,  are  of  a  gastric,  bilious,  or 
pituitous  nature,  the  remedies  which  have  been  indi- 
cated for  those  fevers  \vill  have  to  be  used. 

In  scrofulous  individuals  worm  fevers  have   been 


WORM    FEVER.  179 

several  times  cured  entirely  by  Silicea.  That  Silicea 
is  a  useful  remedy  in  those  fevers,  is  evident  from  the 
power  which  it  possesses  to  occasion  febrile  and  gas- 
tric conditions,  and  from  the  fact  that  the  pathogenetic 
symptoms  of  Silicea  are  more  marked  at  the  time 
when  the  moon  changes,  which  is  likewise  the  case  in 
worm  fevers. 

The  most  powerful  remedy  in  eradicating  the  dispo- 
sition for  worm  diseases  is  Calcarea ;  it  is  entirely 
adapted  to  children  of  a  lymphatic,  fleshy  constitution, 
with  disposition  to  blennorrhcea  and  excessive  secre- 
tion of  mucus,*  to  feeble  individuals  whose  assimila- 
tive functions  are  impaired,  with  pale,  cachectic  com- 
plexion, bloated  countenance,  weak  feet,  chronic  dys- 
pepsia, diarrhoea,  and  when  scrophulosis  and  rickets 
are  present.  Next  to  Calcarea  ranks  Sulphur,  which 
is  especially  adapted  to  lymphatic  and  leuco-phlegma- 
tic  constitutions,  when  a  disposition  to  catarrh  and 
blennorrhoea  is  present,  and  when  the  following  symp- 
toms occur  :  bitter,  slimy  taste  in  the  mouth,  aversion 
to  meat,  irresistible  desire  for  sugar,  alternation  of 
canine  hunger  and  loss  of  appetite,  frequent  regurgi- 
tation  of  food  with  heartburn  and  waterbrash,  hickup, 
gagging,  vomiting,  rumbling  in  the  bowels,  intolera- 
ble itching  of  the  rectum,  with  raw  and  sore  feeling 
of  that  organ,  etc.  Puls.,  Ipec.,  Merc.,  Antim.,  and 
other  remedies,  may  likewise  prove  suitable  for  such 
symptoms. 

Worm  affections  cannot  be  cured  unless  the  diet 
and  mode  of  life  of  the  patient  are  strictly  regulated ; 
the  diet  ought  to  be  nourishing  and  substantial,  the 
principal  food  being  meat ;  vegetable  food,  milk,  flour, 
and,  above  all,  pastry,  ought  to  be  carefully  avoided. 

§  54.  This  seems  to  be  a  proper  place  to  add  a  few 
words  relative  to  the  treatment  of  taenia.  Hahnemann 
says,  in  his  Organon,  that  the  morbid  phenomena  de- 
noting the  presence  of  taenia  can  be  speedily  removed, 
or  rather  quieted,  by  the  smallest  portion  of  the  tincture 
of  Filix  mas  ;  the  taenia  being  calmed,  it  no  longer  ir- 

*  The  German  term  is  "  Verschleimung"  which  convcyg  the  idea  as  if 
everything  were  turned  into  phlegm. 


180  WORM   FEVER. 

ritates  the  bowels  of  the  patient.  Hahnemann  advises 
a  sort  of  palliative  treatment,  until  the  radical  cure  is 
completed  by  means  of  the  antipsorics.  Several  ho- 
moeopathic physicians  agree  with  Hahnemann ;  among 
whom  we  may  particularly  mention  the  name  of 
Hering,  who  advises  to  keep  the  taenia,  which  he  does 
not  consider  as  a  very  great  plague,  rather  than  to  ex- 
pel it  by  violent  means,  lest  some  other  more  danger- 
ous affection  should  appear  in  the  place  of  the  taenia. 
However,  not  to  mention  the  insufficiency  of  this  pal- 
liative treatment,  which  every  physician  will  be  fre- 
quently obliged  to  resort  to,  it  is  absolutely  necessary 
that  we  should  consider  the  express  wish  of  the  pa- 
tient to  have  the  monster  expelled.  If  we  do  not 
comply  with  his  wishes,  he  will  resort  to  nostra  and 
the  pernicious  expedients  of  old  women  and  quacks. 
We  are  so  much  more  justified  in  attempting  the  expul- 
sion of  the  taenia,  as  the  antipsoric  treatment  is  very 
slow  and  very  problematical.  Several  homoeopathic 
physicians  have,  therefore,  been  induced  to  attempt 
that  expulsion,  and  have  indeed  been  successful. 
Gross  recommends  particularly  Graphites,  Calcarea, 
Sabadilla  ;  also  Fragaria  vesca  ;  Hering  recommends 
Sulp.,  Merc.,  and  Calc. ;  besides  these  remedies,  the 
following  deserve  to  be  mentioned  :  Carbo  anim.  and 
veg.,  Kali  carb.,  Magn.  mur.,  Natr.,  Phosp.,  Petrol., 
Plat.,  Stann.,  Tereb.  Stannum  is  recommended  by  a 
number  of  homoeopathic  physicians  as  a  great  reme- 
dy in  worm  affections ;  at  any  rate  it  is  an  excellent 
palliative  for  the  symptoms  of  taenia  and  lumbrici. 
Among  the  remedies  which  have  effected  the  expul- 
sion of  taenia  in  a  short  period  and  directly,  the  first  is 
Filix  mas.  Bicking  has  been  successful  in  almost 
every  case.  He  directed  the  patient  to  drink  a  quan- 
tity of  cold  water,  to  use  cold  water  injections,  and  to 
apply  cold  water  douches  to  the  abdomen.  This  be- 
ing done,  he  gave  the  patient  a  saturated  decoction  of 
Filix  mas  (half  an  ounce  per  diem) ;  he  admits,  how- 
ever, that  the  taenia  was  frequently  reproduced,  but 
speedily  expelled  again  by  similar  means,  without  ever 
reappearing.  Lobethal  affirms  that  the  daily  use  of  a 


WORM    FEVER.  181 

few  drops  of  the  concentrated  tincture  of  Filix  mas 
has  been  quite  sufficient  in  his  hands.  In  the  Horn. 
Gazette,  vol.  ii.,  p.  67,  a  case  of  a  frightful  worm  colic 
is  reported,  which  was  speedily  cured  by  a  single  drop 
of  the  tincture  of  Filix  mas ;  eight  days  after  the  colic, 
fifty  yards  of  taenia  were  discharged  without  the  dose 
having  been  repeated. 

The  same  results  have  been  obtained  by  means  of  Pu- 
nica  granatum.  Lobethal  recommends  that  remedy  in 
very  obstinate  cases.  J.  O.  Miiller  (Hygea,  vol.  x.,  pp. 
137,  193,)  mentions  the  following  symptoms  as  having 
been  removed  by  Punica  granatum  :  convulsive  move- 
ments, catalepsy  and  epilepsy,  fainting  turns,  emacia- 
tion, notwithstanding  a  constant  appetite,  sudden 
waking,  hallucinations,  hypochondria,  vertigo,  stupor, 
trembling  before  the  eyes,  dilatation  of  the  pupils,  yel- 
low complexion,  grating  of  the  teeth,  confluence  of 
water  in  the  mouth,  variable  appetite,  gulping  up  of 
a  watery  fluid,  vomiting,  sensation  in  the  stomach  as 
if  a  body  were  ascending  in  it,,  distended  abdomen, 
colic,  chronic  palpitation  of  the  heart,  etc. 

The  expulsion  of  the  taenia  frequently  succeeds  in  a 
very  peculiar  manner,  and  the  cases  of  cure  which 
will  be  recorded  in  the  following  paragraphs  confirm 
Hahnemann's  rule :  "  Remove  the  perceptible  phe- 
nomena of  disease,  and  health  will  be  restored." 

A  lady  suffered  with  irregularity  of  the  menses ; 
they  occurred  either  too  early  or  too  late,  were  either 
too  profuse  or  too  feeble,  the  menstrual  blood  being 
always  thick,  coagulated,  black.  Several  times  she 
had  been  affected  with  the  most  violent  symptoms  of 
inflammation  of  the  liver,  after  which  a  jaundiced 
complexion  had  remained.  For  some  time  past  she 
had  been  complaining  about  intense  pain  in  the  region 
of  the  liver  and  umbilicus,  recurring  at  intervals,  ac- 
companied with  nausea,  gagging,  vomiting  of  tenacious 
mucus,  yellowish  grey  complexion.  After  having  em- 
ployed the  remedies  which  we  thought  were  indicated, 
without  any  success,  we  exhibited  the  second  tritura- 
tion  of  Argentum  nitricum  crystallisatum,  three  times 
a-day,  each  dose  consisting  of  as  much  of  the  tritura- 


182  FEBRILE   CONDITIONS 

tion  as  would  cover  the  point  of  a  pen-knife.  Eight 
days  after  having  taken  the  medicine,  she  passed  a 
quantity  of  fragments  of  taenia,  all  her  troubles  disap- 
peared, and  have  not  returned  ;  it  is  now  two  years. 
We  were  guided  in  the  selection  of  the  remedy  by  the 
profuse  menstruation,  as  Kopp  advises. 

Another  lady  had  been  affected  \vith  taenia  for  the 
last  seven  years.  The  fragments  which  she  had  occa- 
sionally passed  during  that  period  were  evidences  of 
the  continual  presence  of  the  animal.  The  lady  had 
given  birth  to  two  children,  one  of  whom  was  still 
alive,  but  she  had  never  been  pregnant  since,  owing  to 
the  presence  of  the  taenia.  She  had  gone  through  various 
kinds  of  treatment  for  taenia,  including  the  cold-water 
treatment,  but  without  any  success ;  she  was  now  de- 
termined to  try  homoeopathy.  The  peculiar  pain 
which  she  experienced  in  the  stomach,  the  constipa- 
tion, the  irregular  menses,  which  were  scanty,  and  at 
times  appeared  too  late  and  then  again  too  early,  the 
jaundiced  tinge  around  the  mouth  and  nose,  seemed  to 
require  Nux,  third  attenuation  ;  this  was  given,  and  the 
condition  of  the  patient  soon  improved  to  such  an  ex- 
tent that  the  cure  might  be  looked  upon  as  terminated. 
Some  time  after  she  had  a  violent  chagrin,  which 
brought  back  all  her  former  troubles,  and  required 
Chamomilla,  first  attenuation,  which  effected  an  essen- 
tial improvement,  but  left  the  constipation  as  it  was. 
This  circumstance  leading  us  to  suppose  that  the 
alternate  use  of  those  two  remedies  •would  remove  the 
trouble,  we  put  the  patient  on  Chamomilla  and  Nux, 
giving  her  two  doses  of  the  former  in  the  morning  and 
one  dose  of  Nux  in  the  evening.  Four  days  after 
taking  the  medicine,  the  entire  taenia  was  expelled ; 
soon  after  she  became  pregnant,  and  expects  soon  to 
be  delivered. 

We  may  here  observe  that  the  real  taenia,  bothrio- 
cephalus  latus,  occurs  very  seldom  in  Germany,  the 
taenia  lata  solium  more  frequently. 

§  55.  Febrile  conditions  resembling  Cholera. 

Many  will  say  that  the  various  kinds  of  fever  which 


RESEMBLING    CHOLERA.  183 

we  have  treated  in  the  preceding  paragraphs  are  very 
much  like  the  febrile  conditions  which  we  shall  speak 
of  in  this  chapter,  and  that  the  treatment,  at  any  rate, 
is  very  nearly  the  same.  Although  we  are  willing  to 
admit  that  the  febrile  conditions  which  we  have 
alluded  to  in  the  heading  are  not  essentially  different 
from  one  or  the  other  of  those  fevers,  yet  we  think  that 
we  ought  to  be  as  explicit  as  possible  in  this  work, 
were  it  only  for  the  sake  of  beginners  in  homeopathy, 
for  whom  this  work  is  more  particularly  designed.  It 
is  for  this  reason  that  we  will  make  particular  mention 
of  a  kind  of  cholera  fever  which  is  very  much  related 
to  a  gastric  or  bilious  fever,  and  frequently  occurs  as  a 
sporadic  disease  in  some  parts  of  Germany.  After 
that  we  will  likewise  give  a  minute  account  of  the 
treatment  of  the  Asiatic  cholera,  which  having  ap- 
peared once,  is  likely  to  appear  again  amongst  us  some 
time  or  other. 

The  sporadic  cholera  generally  appears  suddenly 
and  without  any  precursory  symptoms.  If  there  exist 
precursory  symptoms,  they  resemble  those  of  a  sabur- 
ral,  bilious,  and  pituitous  gastroataxia,  or  the  pre- 
cursory symptoms  of  saburral,  bilious,  and  pituitous 
fevers,  such  as:  general  malaise,  heaviness  and  indo- 
lence of  the  body,  yellowish  complexion,  yellow  slimy 
coating  of  the  tongue,  the  root  of  the  tongue  being 
more  thickly  coated  than  the  tip ;  these  symptoms  are 
frequently  accompanied  with  a  slimy,  bitter  taste,  and 
beside  this,  nauseating  bitter  eructations  are  some- 
times present ;  there  is  likewise  a  pressure,  a  crampy 
drawing  and  fulness  in  the  pit  and  region  of  the 
stomach,  with  anxiety ;  flatulency,  nausea,  distention 
of  the  abdomen,  rumbling  and  colicky  pains  in  the 
bowels,  the  urine  causes  a  burning  in  the  urethra,  has 
a  fetid  smell,  and  deposits  a  reddish  sediment. 

If  these  symptoms  be  not  speedily  removed  by  suit- 
able homoBopathic  remedies,  or  if  the  disease  have  no 
precursory  symptoms,  the  symptoms  of  the  disease 
itself  set  in.  In  the  commencement  the  patient  vomits 
suddenly  and  repeatedly,  uwtil  the  ingesta  have  been 
removed  from  the  stomach,  after  this  a  watery,  slimy, 


184  FEBRILE    CONDITIONS 

and  at  last  a  bilious  fluid  is  thrown  off  in  a  larger  or 
smaller  quantity ;  the  substance  which  is  thrown  off 
is  yellow,  green,  brown,  sometimes  blackish,  frequently 
fetid,  causing  renewed  paroxysms  of  nausea  all  the 
time.  This  vomiting  is  accompanied  with  frequent 
and  violent  diarrhoea,  consisting  at  first  of  faeces,  and 
afterwards  of  a  watery  and  bilious  fermenting  liquid ; 
the  diarrhrea  is  generally  accompanied  with  violent 
burning,  cutting  colic,  especially  in  the  umbilical  region. 

If  the  disease  last  longer,  the  following  symptoms 
supervene  :  fulness  in  the  pit  of  the  stomach,  hurried 
respiration  with  anguish,  violent  cardialgia,  spasmodic 
and  sometimes  scarcely  perceptible  pulse.  When  the 
disease  has  reached  its  acme,  the  above-mentioned 
symptoms  attain  their  highest  development,  the  pulse 
and  strength  of  the  patient  collapse  speedily,  and  other 
spasmodic  pains  in  the  bladder  and  the  extremities, 
cold  sweats,  fainting  turns,  and  hippocratic  counte- 
nance, are  sometimes  present. 

§  56.  We  have  already  stated  that  the  sporadic 
cholera  is  most  frequent  in  our  country  (Germany).  In 
hot  summers,  however,  it  may  likewise  break  out  as 
an  epidemic  disease,  without  having  the  character  of 
the  Asiatic  cholera. 

Predisposing  causes  of  sporadic  cholera  are,  un- 
doubtedly, intense  heat  continuing  a  long  while  ; 
catching  cold  suddenly  in  hot  weather ;  an  irritable 
constitution  and  temperament,  as  is  frequently  seen  in 
hypochondriac  and  hysteric  females  ;  childhood,  especi- 
ally during  the  period  of  dentition  ;  violent  emotions, 
such  as  fright,  anger,  vehemence  ;  cold  in  the  abdomen, 
or  by  the  feet ;  cold  food  and  drink,  unripe,  sour, 
watery  fruit,  such  as  peaches,  melons,  grapes  ;  ice  and 
pastry  ;  acrid,  sour,  non-fermenting  drinks ;  fat,  rancid 
food ;  spawn  of  perch,  pike,  and  of  caviar ;  acrid  med- 
icines and  poisons,  like  the  resinous  and  acrid  emetics 
and  cathartics,  jalap,  colocynthis,  mineral  acids,  zinc, 
and  sulphate  of  copper,  tartar  emetic,  mercurial  salts, 
arsenic,  etc.  ;  suppression  of  cutaneous  eruptions,  gout 
and  menstruation.  • 

§  57.  These  kinds  of  cholera  are  of  the  milder  kind. 


RESEMBLING    CHOLERA.  185 

The  precursory  symptoms,  if  there  be  any,  can  be 
easily  removed  by  the  well-selected  homeopathic 
agent.  If  the  characteristic  symptoms  of  the  disease 
have  made  their  appearance,  the  physician  has  to 
select  his  remedy  with  great  care,  lest  it  should  not 
correspond  to  the  symptoms.  The  cases  of  sporadic 
cholera  which  arise  from  overloading  the  stomach, 
from  eating  sour  food,  or  taking  sour  drinks,  from  gen- 
eral or  partial  catarrhs,  cannot  terminate  unfavour- 
ably unless  the  treatment  is  entirely  mismanaged.  In 
making  such  an  assertion,  the  age  and  constitution  of 
the  patient  are  of  course  taken  into  consideration  ;  it 
is  self-evident  that  children,  whose  nervous  system  is 
extremely  irritable,  and  who,  on  that  account,  are  more 
predisposed  to  spasms,  are  more  easily  carried  away 
by  an  attack  of  sporadic  cholera  than  full-grown, 
robust  persons.  It  is  for  similar  reasons  that  cholera 
is  particularly  dangerous  for  old  people  and  females. 

§  58.  The  treatment  of  a  disease  ought  afways  to 
correspond  to  the  exciting  cause.  As  in  most  cases  of 
sporadic  cholera  it  is  impossible  to  assign  a  specific 
cause  for  the  disease,  we  will  commence  with  the 
treatment  of  this  class  of  cholera  cases  and  afterwards 
speak  more  in  detail  of  those  few  cases  where  the  ex- 
citing cause  is  well  known. 

The  precursory  symptoms  which  we  have  mentioned 
above,  yield  in  most  cases  to  a  dose  of  Chamomilla 
more  speedily  than  to  Ipecacuanha,  even  in  cases 
where  one  or  two  diarrhoeic  stools,  with  colic  in  the 
umbilical  region  have  already  taken  place.  Chamo- 
milla would  be  inferior  to  Ipec.,  if  vomiting  and  a  con- 
stant desire  to  vomit,  with  diarrhoea,  had  already  set 
in  ;  in  this  case  Ipec.  may  be  repeated  in  from  one  to 
three  hours,  if  the  first  dose  should  not  have  been  suf- 
ficient to  remove  the  disease. 

If  either  of  those  remedies  should  fail,  and  the  cha- 
racteristic symptoms  of  the  cholera  should  make  their 
appearance,  or  if  the  physician  should  have  been 
called  when  the  disease  had  already  broken  out,  it  is 
advisable  to  administer  at  once  Veratrum  album, 
which  is  the  specific  remedy. 


186  FEBRILE    CONDITIONS 

If  the  characteristic  symptoms  of  cholera  should  be 
accompanied  in  the  very  beginning  with  an  excessive 
prostration  of  strength  altogether  disproportionate  to 
the  vomiting  and  diarrhoaa,  with  great  anguish,  violent, 
unquenchable  thirst,  diarrhoeic  and  sometimes  san- 
guineous discharges  from  the  bowels,  occurring  almost 
every  moment,  vomiting,  excessive  colic,  and  the  like, 
Arsenic  will  be  found  the  best  remedy  if  administered 
in  suitable  doses.  Arsenic  is  likewise  the  best  remedy 
if  Veratrum  had  no  effect  and  the  disease  threatens  to 
pass  into  the  third  stage  ;  even  when  the  hippocratic 
countenance  has  already  set  in,  and  the  pulse  is 
scarcely  perceptible,  Arsenic  may  still  save  the  pa- 
tient's life. 

§  59.  Cholera  symptoms  which  have  been  occasioned 
by  chagrin  are  most  speedily  relieved  by  Chamomilla, 
provided  the  physician  is  called  in  time.  In  many 
cases,  especially  when  the  alvine  evacuations  consist 
principally  of  mucus,  Pulsatilla  is  indicated,  unless 
Colocy nth  .should  correspond  more  accurately  to  the 
symptoms,  which  might  be  the  case,  since,  as  has  been 
stated  above,  Colocynth  is  even  a  better  specific  against 
the  consequences  of  chagrin  than  Chamomilla. 

The  cholera  symptoms  to  which  hypochondriac  and 
hysteric  persons  are  liable  do  not  require  any  different 
treatment  from  the  one  which  is  required  by  cholera 
arising  from  cold  or  errors  in  diet. 

If  the  symptoms  should  have  been  occasioned  by 
poison,  such  as  arsenic,  and  the  patient  should  not  yet 
have  vomited,  the  vomiting  must  be  excited  by  artifi- 
cial means,  in  order  to  remove  the  deleterious  substance 
from  the  stomach  as  soon  as  possible,  and  to  prevent 
its  passing  into  the  circulation.  The  most  expeditious 
means  of  bringing  on  vomiting,  is  to  swallow  a  quan- 
tity of  soap-suds  and  to  tickle  the  fauces  with  a  feather ; 
injections  of  soap- water  ought  to  be  administered  at 
the  same  time.  If  the  vomiting  should  already  have 
been  very  copious,  it  may  be  quieted  by  drinking  a 
quantity  of  rich  milk,  or,  if  no  milk  should  be  had,  oil 
or  mucilaginous  drinks,  or  by  taking  a  little  potash 
which  has  been  shaken  with  oil  or  with  a  solution  of 


RESEMBLING    CHOLERA.  187 

hepar  sulp.  calc.  The  best  antidote  to  Arsenic  is  the 
sesquioxyde  of  iron,  \vhich  has  been  recommended  of 
late.  The  nervous  symptoms  which  remain  after  the 
poison  has  been  neutralized,  cannot  be  expected  to 
yield  to  a  single  homoeopathic  remedy ;  the  first 
remedies  to  be  used  for  such  secondary  affections,  are 
the  antidotes  to  Arsenic  :  Ipec.,  Verat.,  Chin.,  Ferr., 
and  Nux  vomica,  the  remedy  to  be  chosen  in  every 
case  in  accordance  with  the  symptoms. 

If  the  cholera  symptoms  depend  upon  mercurial 
salts,  the  milk  ought  to  be  mixed  with  some  potash 
or  powdered  chalk,  or  the  patient  ought  to  swallow 
the  white  of  an  egg,  which  is  likewise  a  most  excellent 
remedy  for  poisoning  by  copper  ;  after  this  a  solution 
of  Hepar  sulph.  calc.  ought  to  be  administered,  and  if 
any  secondary  affection  remain,  the  antidotes  to  Mer- 
cury ought  to  be  used  against  it. 

The  cholera  symptoms  which  had  been  occasioned 
by  vegetable  poisons,  are  most  certainly  and  thorough- 
ly removed  by  small  doses  of  a  saturated  solution  of 
Camphor ;  of  course,  if  any  poison  remain  in  the 
stomach,  this  is  to  be  removed  above  all  things. 

§  60.  Asiatic  cholera. 

The  Asiatic  cholera  has  been  treated  and  carefully 
observed  by  a  number  of  homreopathic  physicians. 
The  results  which  they  have  obtained,  are  by  far  su- 
perior to  those  of  the  best  allopathic  treatment.  From 
the  observations  of  those  physicians  we  have  been 
enabled  to  deduce  definite  rules  for  the  treatment  of 
cholera,  and  to  indicate  the  remedies  which  have 
proved  specifics  in  that  epidemic. 

The  following  is  a  list  of  the  homo3Opathic  publica- 
tions which  we  now  possess  on  the  subject  of  cholera : 

1.  Hahnemann,  Hofrath  Dr.  S.,  Aufruf  an  denkende 
Menschenfreunde  iiber  die  Ansteckungsart  der  Chole- 
ra.    Leipsic,  1831.     (Address  to  the  thinking  friends  of 
mankind  relative  to  the  mode  in  which  the  cholera 
spreads.) 

2.  Heilung   der   Cholera.     Cothen,    1831.     (Treat- 
ment of  cholera.) 


188  ASIATIC    CHOLERA. 

3.  Heilung  der  Cholera,  nebst  einem  Zusatze,  das 
dietetische  Verhalten  bei  dem  Gebrauche  der  Streu- 
kiigelchen   betreffend.      Nuremberg,    1832.      (Treat- 
ment of  cholera,  with  additions  concerning  the  diet 
which  ought  to  be  observed  while  using  the  pellets.) 

4.  Heilung  und  Ausrottung  der   Cholera,  mit  den 
Regeln   der  homoeopathischen   Diet.     Leipsic,    1831. 
(Treatment  and  extirpation  of  the  cholera,  with  the 
rules  of  homoBopathic  diet.) 

5.  Sendschreiben  iiber  die  Heilung  der  Cholera  und 
Sicherung  vor  Ansteckung  am  Krankenbette,  heraus- 
gegeben  vom  Medicinalrath  Dr.  Stieler.     Berlin,  1831. 
(Address  relative  to  the  treatment  of  cholera,  and  the 
best  means  of  guarding  against  the  cholera-contagium 
at  the  bedside  of  patients.) 

6.  Schubert,  Dr.  J.  A.,  Heilung  und  Verhiitung  der 
Cholera.     Leipsic,  1830.     (Treatment  of  cholera,  and 
the  means  to  prevent  it.) 

7.  Ausziige  brieflicher  Mittheilungen  aus  Wien,  die 
asiatische   Cholera,   deren   Eigenthiimlichkeiten   und 
ihre  homceopathische  Behandlung   betreffend.     Leip- 
sic, 1832.     (Extracts  from  letters  from  Vienna,  con- 
cerning the  character  of  the  Asiatic  cholera,  and  its 
homoeopathic  treatment.) 

8.  Bakody,  Dr.  Joseph  von,  HomoBopathische  Hei- 
lung der  Cholera  zu  Raab  in  Ungarn,  im  Jahre  1831. 
(Homoeopathic  treatment  of  the  cholera  at  Raab,  in 
Hungary.) 

9.  HomoBopathische   Behandlung    der    asiatischen 
Cholera,  nach  Dr.  Hofrath  S.  Hahnemann.     Von  Dr. 
Karl  Kaemmerer  zu  Schwabisch  Gmiind.     Stuttgard, 
1832.    (Homoeopathic  treatment  of  the  Asiatic  cholera.) 

10.  Was  haben  wir  von  der  Cholera  zu  fiirchten  ? 
Von  Dr.  K.  Preu.     Nuremberg,  1831.     (What   have 
we  to  fear  from  the  cholera  ?) 

11.  Du  traitement  homceopathique  du  cholera,  avec 
notes  et  appendice.     Par  F.  F.  Quin,  M.D.,  Medecin 
ordinaire  de  sa  Majeste  Leopold  roi  des  Beiges,  etc. 
Paris,  chez  B.  Bailliere,  libraire  de  1'academie  royale 
de   medecine.      1832.      (Homoeopathic   treatment  of 
cholera,  with  notes.) 


ASIATIC   CHOLERA.  189 

12.  Vier  Vorlesungen  fiber  die  Cholera  in  Europa, 
von  Dr.  J.  Reubel.     Munich,  1831.     (Four  lectures  on 
the  cholera.) 

13.  Bestatigte  Heilung  der  Cholera  durch  homoeo- 
pathische  Arzneien,  von  Dr.   Rohl.     Eisleben,   1832. 
(The  cure  of  cholera  achieved  by  homoeopathic  reme- 
dies.) 

14.  Die  homoeopathische  Heilkunst  in  ihrer  An  wen- 
dung  gegen  die  asiatische  Brechruhr,  dargestellt  von 
Dr.  J.  J.  Roth,  practischem  Arzte  und  Privatdocenten 
an  der  Universitat  zu  Munchen.     Leipsic,  1833.     (The 
homoeopathic  treatment  of  cholera.) 

15.  Die  Heilung  und  Prophilaxis  der  Cholera,  v.  J. 
Eman.  Veith.     Hamm,  1832.     (Curative  and  prophy- 
lactic treatment  of  cholera.) 

Beside  the  above-mentioned  publications,  there  are 
several  interesting  articles  on  the  subject  of  Cholera 
in  the  Homosop.  Gazette,  Vol.  I.,  Nos.  2,  4,  5,  among 
which  Dr.  Rummel's  treatise,  "  On  the  second  appear- 
ance of  the  Cholera  in  Merseburg,"  deserves  particular 
mention.  Hartlaub  and  Trinks  have  collected,  with 
great  care,  the  various  letters  which  have  been  pub- 
lished on  the  subject  of  cholera,  and  have  appended 
them  to  the  third  volume  of  their  Annals.  The  third 
volume  of  Schweichert's  Horn.  Gazette  likewise  con- 
tains a  number  of  interesting  data  relative  to  the 
treatment  of  cholera.  • 

§  61.  From  the  statements  and  observations  relative 
to  the  different  degrees  of  cholera  we  infer,  that  every 
age  and  sex  is  liable  to  the  invasion  of  that  epidemic ; 
little  children  and  old  people  are  least  subject  to  its 
attacks ;  individuals  from  the  25th  to  the  60th  year  of 
age  are  most  easily  affected.  The  inferior  degrees  of 
cholera  seem  to  require  a  more  or  less  marked  predis- 
position to  the  disease,  depending  upon  a  torpid  state 
of  the  abdominal  organs,  upon  the  constitution  of  the 
patient,  upon  temperament,  mode  of  life,  food,  climate, 
locality ;  this  is  the  reason  why  the  cholera  is  more 
frequently  met  among  the  poorer  classes.  The  higher 
degrees  of  cholera  and  the  malignant  form  of  that 
epidemic  make  their  appearance  among  all  classes, 


100  ASIATIC    CHOLERA, 

external  circumstances  having  no  influence  on  the 
character,  course,  and  symptoms  of  the  disease. 

It  is  true  there  are  extreme  degrees  of  violence  and 
mildness  in  cholera,  the  former  being  malignant  and 
speedily  fatal,  the  latter  being  controlled  more  easily ; 
but  between  those  extreme  degrees  there  are  numer- 
ous shades  and  gradations  in  the  first  appearance,  de- 
velopment, violence  and  concatenation  of  the  symptoms, 
most  of  which  are  founded  in  the  individuality  of  the 
patient,  and  have  to  be  observed  with  great  care,  as 
they  determine  the  remedy  which  is  to  be  used  in  the 
case.  Those  degrees  of  violence  occur  much  more 
frequently  in  the  inferior  grades  of  the  disease  than  in 
the  higher  ;  these  are  more  uniform  in  their  principal 
symptoms,  and  the  most  striking  differences  occur  in 
the  nervous  and  muscular  system.  Either  degree  of 
the  disease,  mild  or  intensely  malignant,  has  no  well 
marked  limits.  The  milder  degree  may  easily  pass 
into  the  more  malignant,  but  not  the  reverse. 

From  time  immemorial  we  understand  by  cholera  a 
disease  which  is  characterized  by  the  following  symp- 
toms: the  patient  discharges  by  the  mouth  and  rectum, 
either  continuously  or  at  short  intervals,  with  great 
violence  and  in  profuse  quantities,  a  watery  or  else  a 
watery,  slimy  fluid,  which  is  neither  feculent  nor,  as  a 
general  rule,  bilious  or  sanguineous ;  accompanied  with 
cramp  pains  in  the  abdomen  and  praecordia,  with  or 
without  colic,  properly  so  called,  retention  of  urine, 
sudden  vanishing  of  strength,  which  increases  to  the 
most  excessive  prostration,  painful  spasms  in  the  limbs 
and  trunk  if  the  disease  continue  for  a  certain  length 
of  time,  and  rapid  loss  of  animal  heat.  Cholera  is 
distinguished  from  other  diseases  by  the  fact  that  its 
attacks  come  on  suddenly,  without  any  precursory 
symptoms,  and  with  great  violence ;  that  it  is  either 
entirely  without  any  fever,  or  that  the  fever  is  scarcely 
perceptible,  and  out  of  all  proportion  to  the  intensity 
of  the  symptoms. 

Cholera  has  no  well  marked  periods  or  stages  ;  but 
even  if  they  could  be  defined,  this  would  have  no  sort 
of  practical  value  in  the  more  intense  degrees  of  the 


ASIATIC    CHOLEBA.  101 

disease.  Nevertheless,  authors  have  thought  proper 
to  lay  down  certain  stages,  and  we  will  follow  their 
example. 

First  stage ;  stage  of  the  invasion,  precursory  stage. 
In  the  more  violent  degrees  of  cholera  this  stage  is 
scarcely,  if  ever,  perceived  ;  it  sometimes  lasts  only  a 
few  minutes.  In  the  milder  forms  of  cholera,  the  in- 
vasion is  characterized  more  or  less  by  the  following 
symptoms :  About  twenty  minutes,  and  in  very  rare 
cases  some  days,  previous  to  the  outbreak  of  the  dis- 
ease, the  patient  complains  of  a  general  malaise,  with- 
out considering  himself  sick  ;  he  feels  debilitated,  and 
exertions  fatigue  him  extremely  ;  there  is  an  alteration 
in  the  expression  of  countenance,  the  patient  looks 
anxious,  sad,  apprehensive,  and  a  complete  disfigura- 
tion of  the  countenance  (the  facies  cholerica)  soon 
follows.  The  patient  is  out  of  humour,  restless,  he 
moans,  has  an  aversion  to  anything,  especially  to  food 
and  drink,  complains  of  a  disagreeable  sensation  of 
pressure,  tension,  creeping  or  rumbling  in  the  stomach 
and  bowels,  without  experiencing  any  real  pain,  some- 
times accompanied  with  frequent  eructations  and  slight 
nausea.  The  pulse  is  not  much  changed,  but  upon  the 
appearance  of  the  second  stage  it  becomes  more  rapid, 
and  withal  smaller  and  weaker.  The  skin  feels  dry 
and  cool,  portions  of  the  skin  being  covered  with  a 
slight,  clammy  sweat.  The  abdomen  is  generally 
tense,  bloated,  as  if  too  full,  but  scarcely  ever  painful 
to  pressure.  In  some  cases  the  region  of  the  stomach 
is  somewhat  sensitive,  and  there  is  some  disposition  to 
go  to  stool.  Sometimes  the  patient  complains  of  pres- 
sure in  the  chest,  laboured  breathing,  a  beating  sensa- 
tion in  the  chest,  alternate  chilliness  and  heat.  The 
urine  is  more  scanty  than  usual,  and  is  either  pale  and 
clear  as  in  spasms,  or  else  turbid  and  cloudy.  The  head 
is  generally  without  pain,  but  somewhat  dull,  heavy,  and 
at  times  even  giddy.  Sleep  is  restless,  frequently  in- 
terrupted by  starting  and  jactitation  of  the  limbs. 
Those  symptoms  have  degrees  of  intensity.  The  first 
stage  may  last  from  twenty  minutes  to  twelve,  fifteen, 
or  even  eighteen  hours. 


192  ASIATIC   CHOLERA. 

Second  stage  ;  stage  of  development.  The  symptoms 
which  characterize  the  second  stage  vary,  like  those  of 
the  first,  both  as  regards  intensity  and  duration.  In 
some  cases  the  principal  symptoms  set  in  at  once,  in- 
creasing steadily  until  death  has  taken  place ;  the  first 
and  third  stage  apparently  do  not  set  in.  In  other 
cases  the  symptoms  increase  more  progressively  and 
slowly,  sometimes  they  seem  even  to  remain  stationary, 
and  the  patient  improves,  or,  at  any  rate,  seems  to  im- 
prove. This  improvement,  whether  real  or  apparent, 
soon  gives  way  to  a  new  and  so  much  more  violently 
increasing  aggravation,  which  may  be  considered  the 
third  stage.  Some  practitioners  have  observed,  that 
the  degrees  of  violence  occurring  in  the  second  stage 
depend  principally  upon  the  nature  of  the  locality 
where  the  epidemic  prevails.  This  observation  may 
be  of  importance  in  the  treatment. 

The  second  stage  is  generally  characterized  by  the 
following  symptoms :  sudden  vomiting,  sometimes  pre- 
ceded by  short  nausea,  but  very  seldom  by  real  vomit- 
urition ;  the  food,  which  happens  to  be  in  the  stomach, 
solid  or  liquid,  is  thrown  up  with  a  sudden  jerk  ;  after 
the  first  vomiting  the  patient  sometimes  feels  a  certain 
relief.  Either  simultaneously  or  a  few  minutes  after 
the  vomiting,  diarrhoea  sets  in ;  this  is  papescent  and 
partially  liquid,  the  first  three  or  four  diarrhoeic  stools 
being  intermixed  with  faeces  and  half  feculent,  undi- 
gested food,  slime  and  a  watery  fluid,  accompanied 
with  rumbling  in  the  bowels,  sometimes  with  pinching 
and  real  colic,  which  is  very  seldom  violent,  and  some- 
times entirely  wanting.  The  vomiting  very  soon  re- 
turns, the  diarrhoea  likewise,  the  substances  which 
are  evacuated  both  by  the  mouth  and  rectum  becoming 
more  and  more  fluid,  and  quite  watery.  In  many 
cases  both  kinds  of  evacuations  are  so  frequent  that 
the  patient  is  scarcely  able  to  rise  from  the  chair ; 
sometimes  the  debility  is  so  excessive  that  the  patient 
is  unable  to  leave  his  bed,  and  has  to  be  assisted  in 
bed  every  fifteen  minutes  or  more  frequently,  the  aver- 
age number  of  stools  in  twenty-four  hours  being  from 
thirty  to  forty,  together  with  as  many  vomitings.  It 


ASIATIC   CHOLERA.  193 

is  considered  a  symptom  of  the  worst  kind,  and  of  ap- 
proaching dissolution,  if  the  diarrhoBic  stools  diminish 
in  number  while  the  strength  of  the  patient  and  the 
pulse  decrease  proportionately.  Generally  speaking 
the  number  of  the  evacuations  by  the  bowels  or  mouth 
varies;  sometimes  the  evacuations  are  more  nume- 
rous than  in  sporadic  cholera,  sometimes,  and  this  is 
the  more  frequent,  they  are  less  in  number;  there 
have  been  cases  of  Asiatic  cholera  where  only  a  few 
extremely  copious  and  watery  evacuations  took  place 
in  the  very  commencement  of  the  attack,  occasioning 
excessive  prostration. 

After  the  second,  third  or  fourth  evacuation  all  suc- 
ceeding evacuations  are  watery,  or  of  the  consistence 
and  nature  of  an  albuminous  serum,  or  a  serous  mu- 
cus, or  like  rice-water;  generally  they  are  clear  or 
somewhat  whitish,  inodorous  and  tasteless,  with  albu- 
minous, cheesy,  blackish  flocks,  floating  in  the  midst  ot 
the  liquid.  As  a  general  rule  the  abdomen  caves  in 
after  the  first  diarrhoea  ;  the  whole  body,  in  fact,  sinks 
and  becomes  emaciated  after  the  evacuations  have 
continued  one  or  two  hours.  This  alteration  is  espe- 
cially visible  in  the  countenance.  It  is  remarkable 
that  there  should  not  be  any  bile  either  in  the  evacu- 
ations upward  or  downward ;  even  after  death  no 
trace  of  bile  can  be  discovered  in  the  intestinal  canal. 
The  want  of  bile  is  a  characteristic  phenomenon  in  the 
Asiatic  cholera ;  not  till  the  disease  is  on  the  decrease 
and  an  improvement  sets  in,  do  we  perceive  a  tinge 
of  bile  in  the  alvine  evacuations.  These  evacuations? 
which  become  painless  as  they  continue,  and  finally 
take  place  without  any  sensation,  are  accompanied 
with  a  sense  of  exhaustion  increasing  to  utter  prostra- 
tion. Restless  and  anxious,  the  patient  is  all  the  time 
endeavouring  to  change  his  position,  even  if  he  should 
faint  in  the  effort.  Shortly  after,  slight  twitchings  of 
the  muscles,  or  only  a  drawing. and  tension  in  the 
muscles  of  the  upper  and  lower  limbs,  sometimes  make 
their  appearance ;  sometimes  these  twitchings  amount 
to  violent  and  continuous  spasms  in  the  limbs,  which 
are  extremely  painful,  and  are  characteristic  phenome- 
9 


194  ASIATIC    CHOLERA. 

na  in  cholera.  These  spasms  first  commence  in  the 
toss,  fingers  and  hands ;  afterwards  in  the  calves,  etc. 
Sometimes  the  spasms  are  tonic  or  tetanic,  in  which 
case  they  are  the  most  painful,  and  make  the  limbs 
immoveable,  and  stiff  and  hard  as  wood  ;  generally 
the  spasms  assume  the  form  of  chronic  convulsions. 
The  spasms  affect  most  frequently  the  calves,  forearms 
and  hands. 

These  spasms  are  accompanied  by  an  increasing 
but  not  suffocative  oppression  of  the  chest,  and  tight- 
ness of  breathing,  increasing  anxiety,  vertigo,  and  prin- 
cipally a  sudden  collapse  and  excessive  smallness  of 
the  pulse  which  frequently  disappears  entirely  a  long 
time  before  death,  or  is,  at  any  rate,  scarcely  percep- 
tible. The  same  statement  applies  to  the  beating  of 
the  heart.  The  sudden  collapse  of  pulse  is  one  of  the 
most  remarkable,  and,  at  the  same  time,  one  of  the 
most  essential  symptoms  of  this  epidemic.  This  col- 
lapse of  pulse  appears  to  be  dependent  upon  an  arrest 
of  the  circulation  rather  than  upon  spasm. 

Simultaneously  with  these  symptoms,  or  before,  the 
patient  experiences  a  disagreeable,  painful  burning  in 
the  epigastric  region,  or  in  the  region  of  the  stomach 
down  to  the  umbilicus.  According  to  Annesley,  this 
burning,  which  is  sometimes  experienced  behind  the 
sternum,  and  is  one  of  the  most  constant,  most  distress- 
ing, and  most  alarming,  symptoms,  is  so  characteristic 
of  cholera — that,  whenever  it  exists  in  connexion  with 
the  anxious  look,  with  sighing  and  anxious  breathing, 
one  may  safely  infer  from  it  the  existence  of  cholera. 
The  burning  remains  frequently  a  long  while  after  the 
vomiting  has  ceased,  accompanied  with  a  burning  and 
tormenting  thirst,  the  patient  expressing  a  particular 
desire  for  cold  wrater,  \vhich  he  swallows  with  great 
avidity,  and  throws  up  again  immediately. 

Simultaneously  with  the  spasms,  and  sometimes  a 
little  before,  the  whole  surface  of  the  body  becomes 
cold ;  first  the  lower  limbs  and  then  gradually  the 
"whole  body.  This  coldness  increases  to  a  coldness  as 
of  a  dead  body  (frigus  marmoreum).  .  It  resists  the 
most  persevering  means  of  warming,  and  spreads 


ASIATIC    CHOLERA.  195 

over  the  face  and  lips,  which  become  pale,  blue  and 
cold,  and  over  the  cheeks  and  eyelids ;  even  the 
buccal  cavity,  the  breath  and  tongue,  become  cold. 
The  tongue  is  either  little  or  not  at  all  coated  ;  more 
frequently  it  is  dry,  reddish  or  whitish,  with  brown 
edges  ;  it  becomes  shrivelled  when  getting  cold  (this 
shrivelled  appearance  of  the  tongue  is  considered  a 
particularly  fatal  symptom),  without  being  insensible, 
and  becomes  entirely  bloodless.  The  skin  is  covered 
with  a  cold,  clammy  sweat,  which  is  frequently  very 
profuse.  The  whole  body  becomes  flaccid  and  sunken, 
and  assumes  a  shrivelled  appearance,  especially  on 
the  hands,  fingers  and  toes,  as  if  these  parts  had  been 
soaked  in  warm  water,  with  a  livid,  bluish  hue. 

The  face  is  excessively  disfigured,  sunken,  pale  or 
livid,  cadaverous,  with  cold,  bluish  tip  of  the  nose ; 
cold  sweat,  the  eyes  having  retreated  deep  into  the 
orbits,  half-closed,  dim,  having  very  often  a  reddish, 
and  sometimes  a  blue,  tinge,  they  are  turned  upward, 
and  are  surrounded  with  grey-brown  margins.  This 
expression  of  countenance  is  termed  facies  cholerica  ; 
it  reflects  anxiety  and  sadness ;  the  patient  has  a 
staring  and  vacant  look,  and  appears  to  be  complete- 
ly absorbed  in  reverie.  The  facies  cholerica  is  one 
of  the  most  striking  characteristics  of  the  higher  de- 
gree of  the  disease,  and  is  indeed  a  frightful  and 
ghost-like  appearance. 

The  peculiar  alteration  of  the  voice  is  likewise  re- 
markable. The  voice  of  a  cholera  patient  is  feeble, 
fine,  somewhat  hoarse,  hollow,  or  without  resonance  ; 
the  patient,  being  extremely  averse  to  talking,  uses  his 
voice  only  to  complain  of  the  burning  in  the  pit  of  the 
stomach,  and  to  ask  for  water. 

The  urine  either  ceases  to  flow  from  the  very  com- 
mencement, or  the  patient  passes  only  occasionally  a 
few  drops  of  a  turbid  or  brownish  urine.  This  is  not 
retention  of  urine,  but  the  secretion  of  urine  ceases 
entirely.  This  cessation  of  the  functions  of  the  blad- 
der is  a  striking  and  constant  symptom  of  the  cholera. 
Not  until  the  violence  of  the  disease  decreases,  and 
the  circulation  becomes  freer,  is  the  urine  secreted 


196  ASIATIC  CHOLERA. 

again,  which  may  always  be  considered  a  favourable 
symptom. 

The  secretion  of  mucus  is  not  changed,  only  less 
copious  ;  the  saliva  is  more  viscid  ;  the  nasal  mucus  is 
generally  wanting. 

This  stage  lasts  from  two  to  three,  up  to  eight,  twelve, 
or  twenty-four  hours,  sometimes  two  or  three  days. 

The  third  stage  cannot  well  be  separated  from  the 
former,  for  this  stage  either  passes  into  the  highest 
degree  of  the  disease,  the  stadium  lethale,  or  into  the 
stage  of  convalescence.  The  fatal  stage  is  simply  an 
aggravation  of  the  symptoms  which  we  have  described 
as  belonging  to  the  second  stage  ;  sometimes  vomiting, 
diarrhoea,  spasms,  abate  shortly  before  death,  the 
patient  falls  into  a  kind  of  sopor,  the  heart  ceases  to 
beat,  the  eyes  become  glassy,  etc. 

If  an  improvement  set  in,  the  pulse  becomes  fuller 
and  more  equal,  the  animal  heat  returns,  and  the 
spasms  cease  ;  the  expression  of  countenance  becomes 
more  natural,  cheerful,  anxiety  is  no  longer  depicted 
in  it ;  the  look  is  firmer  and  more  animated ;  there  is  a 
•warm  exhalation  from  the  skin  ;  the  watery  diarrhoea 
diminishes,  the  vomiting  ceases,  the  alvine  evacuations 
again  assume  a  bilious,  sometimes  greenish  tinge  ;  the 
urine  is  secreted  again. 

§  62.  The  prognosis  is  quite  different  from  that  of 
sporadic  cholera ;  the  course  of  the  Asiatic  cholera 
being  extremely  rapid.  Generally  the  attack  termin- 
ates in  asphyxia  after  two  or  three  hours  ;  very  seldom 
the  disease  lasts  two  or  three  days.  If  its  course 
should  be  slow,  and  if  the  disease  should  pass  into  a 
typhoid  fever,  this  may  likewise  be  fatal.  It  is  true 
the  homoeopathic  treatment  of  Asiatic  cholera  is  much 
more  favourable  than  that  of  allopathic  physicians  ; 
nevertheless,  the  physician  has  to  be  constantly  watch- 
ful lest  he  should  overlook  the  dangerous  moment.  A 
chronic  weakness  of  the  nerves,  and  particularly  of  the 
digestive  organs,  frequently  remains.  According  to 
Hahnemann,  and  several  other  physicians,  the  best 
remedy  to  prevent  the  complete  development  of  the 
disease  is  Camphor.  For  this  purpose  one  part  of 


ASIATIC    CHOLERA.  197 

Camphor  is  dissolved  in  twenty  parts  of  alcohol,  and 
the  patient  should  take  one  or  two  drops  of  the  solu- 
tion every  two  or  five  minutes  upon  a  piece  of  sugar, 
or  in  a  spoonful  of  water,  according  as  the  disease  is 
more  or  less  violent.  As  the  symptoms  abate,  the 
Camphor  is  given  at  longer  intervals,  of  course.  Ac- 
cording to  some,  Camphor  simply  palliates  the  symp- 
toms, especially  in  those  cases  where  the  evacuations 
have  existed  for  some  time  previous  to  the  attack. 
The  external  application  of  Camphor -by  fumigation, 
friction,  and  injection,  is  not  only  inexpedient,  but 
positively  injurious,  inasmuch  as  Camphor  would  anti- 
dote almost  all  the  vegetable  medicines  which  the  phy- 
sician might  have  to  use  in  case  Camphor  should  not 
be  sufficient. 

The  highest  potencies  of  Veratrum  and  Cuprum, 
one  or  two  pellets  alternately  every  four  days,  have 
been  recommended  as  preventives  against  the  Cholera. 
A  number  of  homeopathic  physicians  recommend 
Veratrum  exclusively  as  a  preventive.  While  either 
of  those  remedies  is  used,  wine,  coffee,  strong  tea  and 
any  kind  of  spice  are  to  be  avoided. 

Besides  Camphor  the  following  remedies  have  been 
found  curative  in  this  epidemic :  Veratrum,  Cuprum, 
Arsenic,  Nux  v.,  Aconite,  Ipec.,  Chamom.,  Secale  cor- 
nut.,  Tartar,  stib.,  Acid,  phosph.,  Phosphor., Cicutavir., 
Laurocerasus,  Merc,  sol.,  Carbo  veg.,  etc. 

According  to  all  accounts,  Veratrum  is  the  principal 
specific  for  Cholera,  even  where  no  evacuations  have 
previously  existed.  It  has  to  be  repeated  every  15 
minutes,  or  every  half  hour  or  hour,  according  as  the 
disease  is  more  or  less  violent.  Even  when  the  im- 
provement has  commenced,  it  is  still  necessary  to 
repeat  the  remedy,  except  at  longer  intervals.  If  the 
patient  should  have  a  second  attack,  the  same  course 
of  treatment  is  to  be  pursued  as  during  the  first 
attack  ;  sometimes  however  another  medicine  is  re- 
quired, as  the  second  attack  scarcely  ever  is  like  the 
first. 

Arsenicum  is  indicated  when  the  attack  sets  in  from 
the  commencement  with  the  most  violent  symptoms, 


198  ASIATIC   CHOLERA. 

and  the  patient  complains  of  a  most  violent  burning  in 
the  epigastrium,  in  the  bowels  and  throat,  accompanied 
with  a  painful  oppression  of  the  chest,  burning  thirst, 
excessive  debility,  a  constant  tossing  to  and  fro  ;  great 
anguish,  irresistible  dread  of  death,  hoarse  cries 
about  violent  pains  in  the  pit  of  the  stomach  and  ab- 
domen. Arsenicum  as  well  as  Veratrum  ought  to  be 
given  at  somewhat  longer  intervals  than  Camphor. 

Ipecacuanha  is  an  excellent  remedy  when  the  vomit- 
ing is  more  considerable  than  the  diarrhoea.  Jpec.  will 
never  be  found  suitable  when  the  disease  has 
reached  the  acme  of  its  paroxysm,  but  it  will  arrest 
the  vomiting  which  may  yet  continue  after  the 
violence  of  the  disease  shall  have  been  broken.  Ipec. 
has  to  be  repeated  at  least  as  frequently  as  Veratrum  ; 
this  remedy  is  frequently  indicated  after  Ipec.  Nux 
may  be  found  suitable,  if  Ipec.  should  have  arrested 
the  vomiting  and  the  following  group  of  symptoms 
should  have  remained :  symptoms  of  spasm  in  the 
stomach,  a  kind  of  weight  in  the  stomach  with  anguish 
emanating  from  the  pit ;  pains  in  the  bowels  with 
frequent  small  evacuations,  and  a  continual  desire  to 
evacuate  the  bowels,  accompanied  with  headache, 
especially  a  pressure  in  the  sinciput,  slight  febrile 
shiverings,  coldness  more  internal  than  external.  The 
Russian  physicians  have  found  Ipec.  particularly  use- 
ful. 

Cuprum  has  to  be  repeated  the  same  as  every  other 
remedy.  It  is  particularly  applicable  when  the  mus- 
cles are  affected  with  violent  spasms,  when  there  is 
restlessness,  coldness  of  the  prominent  parts,  such  as  the 
face,  distortion  of  the  eyes,  sometimes  accompanied 
with  abdominal  spasms;  there  is  no  vomiting.  When 
those  symptoms  occur,  it  is  sometimes  expedient  to 
exhibit  Cuprum  alternately  \vith  Veratrum.  When 
tetanus  or  trismus  is  present,  Camphor  is  said  to  be 
superior  to  Cuprum. 

Tartarus  emeticus  may  likewise  be  recommended  as 
a  remedy  for  Asiatic  cholera.  Among  its  physiological 
effects  we  notice  the  following  cholera  symptoms: 
spasmodic  movements,  spasmodic  jactitation  of  the 


ASIATIC    CHOLERA.  199 

muscles,  trembling  of  the  limbs,  debility  as  if  one  would 
fall  over,  fainting  sort  of  weakness,  trembling  pulse  or 
collapse  of  pulse,  the  peculiar  paleness  of  countenance 
occurring  in  cholera,  croaking  voice,  cramps  in  the 
calves,  and  above  all  other  symptoms,  the  gastric  de- 
rangement which  characterizes  an  attack  of  cholera. 
It  deserves  consideration  in  cases  where  feculent 
substances  are  still  discharged  from  the  bowels,  in 
cholera  biliosa,  or  at  the  first  onset  of  Asiatic  cholera, 
or  else  towards  the  termination  of  the  attack,  when  the 
vitality  of  the  abdominal  organs  is  still  depressed. 

Cicuta  virosa  is  said  to  be  an  excellent  remedy  when 
the  following  symptoms  occur :  violent  spasms  in  the 
muscles  of  the  chest,  continual  vomiting,  little  diar- 
rhoea, the  eyes  are  turned  upward,  and  a  soporous 
condition  prevails.  Hummel  employed  this  remedy  in 
a  case  characterized  by  similar  symptoms,  after  he  had 
previously  given  two  doses  of  Hydrocyanic  acid.  Ci- 
cuta corresponds  more  particularly  to  neglected  cases, 
and  is  therefore  more  suitable  to  the  secondary  affec- 
tions of  cholera  than  to  the  cholera  itself.  When  the 
symptoms  which  have  been  mentioned  in.  this  para- 
graph occur,  Stramonium  may  likewise  prove  valuable. 

Carbo  vegetabiiis,  according  to  Rummel  in  the  12th, 
and  according  to  others  in  the  30th  potence,  is  said  to 
be  an  excellent  remedy  after  the  peculiar  cholera 
symptoms  have  been  subdued,  when  the  spasms  and 
the  vomiting  have  entirely  ceased,  congestions  of  the 
chest  or  head  set  in,  the  oppression  of  the  chest  is  a 
prominent  symptom,  a  slight  sopor  is  present,  the  flushed 
cheeks  are  covered  with  clammy  sweat,  or  the  patient 
lies  in  a  state  of  complete  asphyxia.  One  or  two 
doses  of  Hydrocyanic  acid  sometimes  require  to  be 
given  prior  to  the  Carbo.  An  hour  after  the  Acid  the 
Carbo  may  be  given,  the  good  effect  of  which  is  recog- 
nized by  the  return  of  the  pulse,  and  sometimes  of  the 
true  cholera  symptoms  ;  these  then  yield  to  Veratrum 
or  Cuprum.  We  may  infer  from  these  indications  that 
the  Carbo  is  less  suitable  to  real  cholera  than  to 
neglected  or  protracted  cases  of  that  epidemic,  or 


200  ASIATIC   CHOLERA. 

when  the  cholera  threatens  to  pass  into  secondary 
typhoid  affections, 

Laurocerasus  is  gfven  by  some  physicians  when  the 
following  symptoms  are  prevalent:  small  and  slow 
pulse,  vertigo,  stupefaction,  convulsive  spasms  of  the 
muscles  of  the  face,  etc.  According  to  our  own  judg- 
ment this  is  not  a  good  remedy  in  cholera ;  it  is  our 
opinion  that  a  good  deal  of  valuable  time  is  lost  by 
resorting  to  that  remedy  in  cholera,  The  symptoms 
previously  mentioned  do  not  indicate  Laurocerasus, 
but  rather  Veratrum  or  Cuprum. 

According  to  RummePs  experience,  a  distinguished 
remedy  in  cholera  is  Secale  cornutum,  lower  potencies, 
from  one  to  three  doses,  when  the  following  group  of 
symptoms  exists:  the  vomiting  has  either  ceased  entire- 
ly, or  for  the  most  part ;  the  colour  of  the  stools  remains 
unchanged,  and  there  is  every  indication  that  no  bile  is 
poured  into  the  intestinal  canal.  Soon  after  the  use  of 
Secale  cornutum,  yellow  and  green  stools  make  their 
appearance  ;  as  soon  as  this  takes  place,  the  patient 
maybe  considered  out  of  danger.  The  pains  in  the 
extremities  likewise  abate  during  the  exhibition  of 
Secale. 

This  remedy  seems  to  be  an  excellent  remedy  in  the 
so-called  cholerine,  for  which  Camphor,  Merc,  sol., 
Phosphorus,  and  Acidum  phosphor,  are  likewise  re- 
commended. The  last  of  those  remedies  is  said  to  be 
indicated  when  the  tongue  is  thickly  covered  with 
mucus.  The  Russian  physicians  have  made  frequent 
and  successful  use  of  Merc.  sol.  in  the  treatment  of 
cholera. 

Every  homceopathic  physician  will  easily  distinguish 
the  symptoms  for  which  Aconite  is  indicated  ;  they  do 
not  require  any  further  notice. 

If  cholera  patients  have  been  treated  allopathically 
before  the  homo3opathic  treatment  commences,  it  is  in- 
dispensable to  give  them,  in  the  first  place,  repeated 
doses  of  Camphor,  partly  to  excite  the  reactive  power 
of  the  organism,  and  partly  to  neutralize  the  large 
doses  of  allopathic  drugs. 


ASIATIC    CHOLERA.  201 

§  63.  The  following  remedies  have  been  used  for  the 
secondary  affections  of  cholera  :  Aconite,  Belladonna, 
Bryonia,  Rhus,  Nux  v.,  Tinct.  sulph.,  Cantharides, 
Acid,  phosp.,  Phosph.,  China,  Hyosciam.,  Stramonium, 
Carbo,  Opium,  etc.  The  secondary  affections  of 
cholera  generally  take  the  form  of  malignant  typhoid 
fevers,  of  which  we  shall  treat  hereafter. 

If  there  be  a  predominance  of  congestive  or  inflam- 
matory symptoms,  one  or  two  doses  of  Aconite  ought 
to  be  given  first.  If  there  be  a  good  deal  of  cerebral 
congestion,  if  it  be  characterized  by  sopor,  with  the 
eyes  half  open  and  turned  upward,  by  inability  to  wake, 
and  to  recollect  things,  to  such  an  extent  that  the 
patients  sometimes  forget  to  draw  in  the  tongue  which 
they  protruded  a  moment  ago ;  by  grating  of  the  teeth, 
distortion  of  the  mouth,  excessive  restlessness,  painful 
stitches  in  the  side  or  abdomen ;  very  quick,  and  more 
or  less  full,  but  not  hard  pulse  ;  burning  heat  and  red- 
ness, with  great  desire  for  cold  drinks,  Belladonna  is 
particularly  serviceable.  Next  to  Belladonna  Cantha- 
rides is  the  best  remedy,  especially  if  the  following 
symptoms  prevail;  rumbling  in  the  abdomen,  some- 
times bloody  stools  preceded  by  tenesmus,  heat  in  the 
bowels,  and  sensation  of  violent  burning  in  the  hypo- 
gastrium,  great  restlessness  ;  the  bladder  is  frequently 
affected. 

In  congestion  of  the  chest  and  lungs,  Aconite,  Bryon., 
Bellad.,  Phosph.,  Sulph.,  Carbo  anim.,  and  Rhus,  are 
the  principal  remedies  ;  these,  together  with  Mercurius 
and  Nux,  are  likewise  the  principal  remedies  when 
the  stomach  and  bowels  are  chiefly  affected. 

For  typhoid  fevers  consequent  upon  cholera,  the  fol- 
lowing remedies  have  been  employed  with  success,  if 
exhibited  in  accordance  with  the  symptoms:  Acid 
phosp.,  Rhus.,  Bryo.,  Bellad.,  Hyosciam.,  Stram.,  Carbo 
anim.,  Opium.  General  debility  remaining  after  the 
cholera  has  been  generally  relieved  by  China.  Weak- 
ness of  the  intestinal  canal,  which  is  characterized  by 
continual  liquid  stools,  is  most  certainly  removed  by 
the  tincture  of  Sulphur,  and  Phosphorus. 

During  the  period  of  convalescence  in  gastric  fevers, 
9* 


202  DYSENTERIC    FEVERS. 

which  is  always  characterized  by  a  want  of  appetite, 
the  following  remedies  deserve  careful  consideration : 
Rhus,  Cyclamen,  Veratrum,  Arsenic,  Acid,  nitricum  ;  if 
an  immoderate  appetite,  a  kind  of  bulimy,  be  present, 
Rhus,  Calc.  carb.,  Lycop.,  Natrum  mur.  are  indicated. 

The  best  beverage  during  an  attack  of  Asiatic 
cholera  is  ice-water ;  this  is  the  only  beverage  which 
will  stay  with  the  patient.  Warm  drinks  do  not  agree 
with  cholera  patients.  Injections  of  ice-water  are 
likewise  useful ;  in  some  cases  injections  of  starch  are 
said  to  have  done  good. 

If  the  cholera  should  invade  a  district,  the  mode  of 
life  should  not  be  changed  suddenly  ;  on  the  contrary, 
it  is  advisable  that  every  body  should  continue  his 
ordinary  mode  of  life,  and  should  simply  avoid  irregu- 
larities. Acids,  stimulating  drinks,  indigestions,  colds, 
debilitating  exertions,  and  depressing  emotions,  are 
prejudicial,  and  should  be  carefully  avoided. 

§  64.  Dysenteric  fevers  ;  dysentery. 

Authors  have  made  a  mistake  in  classing  those 
fevers  among  chronic  diseases.  The  dysenteric  fever 
ought  to  be  considered  an  acute  disease  for  this  reason, 
that  it  may  be  either  endemic  or  epidemic,  and,  when- 
ever it  appears,  has  either  one  or  the  other  of  those  two 
forms  ;  that  it  generally  depends  upon  cosmic  and  tel- 
luric, or  atmospheric  influences  of  some  kind,  and  that 
its  outbreak  is  favoured  by  errors  in  diet.  Moreover, 
the  disease  is  characterized  by  a  sort  of  catarrhal 
irritation  in  the  mucous  membranes  of  the  intestines, 
and  especially  the  large  gut,  which,  like  the  irritation 
in  the  bronchi,  may  assume  an  inflammatory  character 
and  occasion  a  sort  of  erethic  fever  which  accompa- 
nies every  inflammatory  irritation  of  the  mucous 
membranes.  A  dysenteric  fever  might  also  be  char- 
acteristically designated  as  a  febrile  catarrh  or  rheu- 
matism of  the  large  intestines. 

Diagnosis :  constant  urging,  tenesmus,  with  violent 
cutting  colic,  without  any  evacuation  of  faeces,  properly 
so  called  ;  the  patient  merely  discharges  mucus  and 
blood,  and  complains  of  fever.  These  are  constant 


DYSENTERIC    FEVERS.  203 

symptoms.  This  shows  that  the  disease  is  not  charac- 
terized by  diarrhoea,  but  by  constipation,  and  that 
dysentery  and  diarrhoea  are,  so  to  say,  opposite  dis- 
eases. In  diarrhoea  we  have  discharge  of  decayed 
contents  of  the  bowels ;  in  dysentery  those  contents 
are  retained.  Diarrhoea  frequently  gets  well  of  itself ; 
dysentery  very  seldom.  If  feculent  substances  are 
again  discharged  from  the  bowels,  and  the  pains  and 
fever  abate,  then  the  dysenteric  patient  may  be  said  to 
be  recovering  (Hufeland).  If  the  disease  should  set  in 
with  great  violence,  which  is  sometimes  the  case  in 
young,  vigorous,  or  sensitive  individuals — in  which 
case  it  may  assume  the  form  of  a  synochal  fever — 
the  precursory  stage  is  either  entirely  wanting  or  is 
very  short.  The  precursory  stage  is  mostly  met  in 
torpid,  phlegmatic  individuals,  or  when  the  disease  is 
sporadic  ;  in  such  cases  the  fever  has  the  erethic  form. 

If  there  be  no  precursory  stage,  the  course  of  the 
disease  is  short ;  if  a  precursory  stage  exist,  the  dis- 
ease has  a  long  run,  and  frequently  passes  in'o  a 
chronic  dysentery.  The  precursory  symptoms  are : 
want  of  appetite,  pressure  in  the  region  of  the  stomach 
and  dull  colic,  loathing,  nausea,  inclination  to  vomit, 
dirty  coating  of  the  tongue,  bad  taste,  flatulency, 
diarrhoea  ;  general  laxness  and  debility  ;  malaise,  rest- 
less sleep  ;  drawing  in  the  limbs,  increased  sensitive- 
ness to  cold  air,  shiverings,  slight  chills,  accelerated 
pulse. 

The  first  commencement  of  the  disease  is  a  cessation 
of  the  bilious  stools,  and  setting  in  of  an  unsuccessful 
urging,  resulting  simply  in  the  discharge  of  some 
mucus  (dysenteria  alba).  Little  by  little  the  most 
violent  cutting  and  colic  are  experienced  in  the  umbil- 
ical region,  with  sensation  of  burning,  thence  extend- 
ing over  the  whole  abdomen,  and  immediately  preceding 
every  succeeding  evacuation.  As  the  irritation  in- 
creases, the  slimy  evacuations  appear  mixed  with  blood. 
The  most  intensely  painful  symptom  now  is  the  tenesmus, 
a  sensation  as  if  the  bowels  would  protrude,  occasion- 
ing a  constant  renewal  of  the  stools,  which  often  be- 
come excessive  in  twenty-four  hours,  and  spread  a 


204  DYSENTERIC    FEVERS. 

peculiar  smell.  The  fever  is  proportionate  to  the  de- 
gree and  violence  of  the  disease,  and  generally  does 
not  make  its  appearance  until  the  permanent  symp- 
toms of  dysentery  have  all  set  in.  That  fever  is  a 
continua  remittens,  having  in  most  cases  a  rheumatic, 
catarrhal,  or  bilious  character  ;  it  commences  with  a 
succession  of  moderate  chills,  followed  by  moderate 
heat.  The  exacerbation  generally  takes  place  in  the 
evening,  and  is  accompanied  with  a  perceptible  aggra- 
vation of  the  local  symptoms. 

§  65.  The  disease  is  occasioned  by  various  remote 
causes,  the  principal  being  the  suppression  of  some 
kind  of  cutaneous  action,  with  increase  of  acrid  bile. 
This  is  the  reason  why  dysentery  prevails  almost  ex- 
clusively towards  the  end  of  summer,  in  the  months  of 
August  and  September,  when  the  days  are  very  hot 
and  the  nights  very  cool.  At  that  season  of  the  year 
dysentery  is  almost  always  epidemic.  The  disease  is 
endemic  in  low,  damp,  marshy  regions,  where  inter- 
mittent fevers  are  likewise  prevalent ;  in  such  districts 
dysentery  occurs  almost  every  year.  In  epidemic 
dysentery  the  putrid  emanations  from  the  stools  fre- 
quently develope  a  contagium  by  means  of  which  the 
disease  spreads  rapidly  and  over  a  large  extent  of 
country. 

Other  exciting  causes  are :  unripe,  acrid,  watery 
fruit ;  vegetables  covered  with  mildew  ;  corrosive 
poisons,  worms,  haemorrhoidal  congestions,  metastasis, 
difficult  dentition.  The  -  prevailing  type  or  character 
of  disease  becomes  easily  ingrafted  upon  the  dysen- 
tery, and  may  convert  it  into  a  catarrhal,  rheumatic, 
gastric,  bilious,  or  typhoid  dysentery,  although  every 
one  of  those  varieties  may  likewise  be  occasioned  by 
the  individuality  and  constitution  of  the  patient. 
Children  and  females  are  principally  affected  by  that 
disease. 

Chronic  affections  are  sometimes  roused  by  an  at- 
tack of  dysentery,  and  may  in  their  turn  complicate  the 
disease,  and  make  the  prognosis  more  or  less  doubtful ; 
although  the  termination  of  the  disease  does  not  de- 
pend exclusively  upon  the  complication,  but  also  upon 


DYSENTERIC    FEVER9.  205 

the  greater  or  lesser  intensity  of  the  dysentery  itself. 
As  the  disease  increases,  inflammation  supervenes,  an 
excessive  quantity  of  putrid  bilious  substances  is  ex- 
pelled from  the  system,  and  the  patient  is  extremely 
debilitated.  All  these  symptoms  may  occasion  death 
if  the  patient  be  not  carefully  treated,  and  the  most 
unfavourable  prognosis  has  to  be  given  if  a  sudden  ces- 
sation of  the  intense  pain,  sunken  countenance,  cold- 
ness of  the  extremities,  a  small  intermittent  pulse,  fetid 
evacuations,  which  the  patient  passes  without  con- 
sciousness, indicate  the  setting  in  of  mortification. 

The  post-mortem  examination  shows  that  the  disease 
is  seated  in  the  mucous  membrane  of  the  large  intes- 
tines. This  membrane  is  swollen,  red  and  injected, 
softened  (the  softened  parts  being  red  and  bleeding)  ;  a 
serous  exudation  is  perceived  in  the  shape  of  a  fine 
miliary  vesicular  eruption,  which  results  in  the  scaling 
off  of  the  epithelium  of  the  inner  walls  of  the  large 
intestine.  These  appearances  characterize  the  lower 
degrees  of  dysentery  ;  in  the  higher  degrees  larger  sur- 
faces are  affected,  and  the  mucous  membrane  is  covered 
with  a  dingy  grey,  glutinous  exudation,  accompanied 
with  prominences  which  are  formed  by  a  copious 
serous  infiltration  of  the  submucous  cellular  tissue. 
This  degenerative  process  increases  until  a  dark  red  or 
black  brown  sanguineous  exudation  has  resulted  from 
it,  which,  in  the  highest  form  of  the  disease,  becomes 
a  black,  friable,  tearable,  and  almost  carbonized  mass. 

§  66.  We  now  pass  to  the  treatment  of  dysentery, 
commencing  with  naming  the  remedies  which  have 
been  used  against  the  various  kinds  of  the  disease 
generally.  The  principal  remedy  is  Mercurius  corro- 
sivus,  next  to  which  we  rank  Mercurius  solub.  H.,  and 
other  mercurial  preparations  ;  Colchicum  autumnale, 
Capsicum,  Carbo  veg.,  Colocynth,  Ipecac.,  Aloes,  Can- 
tharides,  Acidum  nitric.,  and  Sulphur ;  Flores  and 
Hepar  sulph.,  Rhus,  Staphysag.,  Nux  vom.,  Bellad., 
Pulsat.,  Chamom.,  Arsenic,  China,  Tart,  emet.,  Sepia, 
Plumbum,  Veratrum. 

Those  kinds  of  dysentery  which  authors  have  deno- 
minated catarrhal  rheumatic,  and  which  do  not  occa- 


206  DYSENTERIC    FEVERS. 

sion  any  great  derangements  in  the  digestive  functions, 
offer  a  variety  of  rheumatic  complaints,  together  with 
the  characteristic  symptoms  of  dysentery,  such  as : 
drawing  and  shooting  stitches  in  the  muscles  and  ex- 
tremities, tearing  in  the  nape  of  the  neck,  in  the  head 
and  shoulders.  The  fever  is  a  continua  remittens ; 
the  local  intestinal  affection  which  sets  in  simultane- 
ously with  the  fever  is  not  very  violent,  the  evacua- 
tions generally  consist  of  mucus,  and  are  streaked 
with  blood. 

This  kind  of  dysentery  is  generally  epidemic,  but  it 
sometimes  exists  as  a  sporadic  disease,  and  generally 
accompanies  catarrhs,  rheumatisms,  and  diarrho3a  ;  it 
is  principally  occasioned  by  variable,  alternately 
warm  and  cool  and  damp  weather,  and  is  frequently 
endemic  in  those  districts  where  climate  and  locality 
make  fever  and  ague  likewise  endemic. 

If  the  attack  have  been  occasioned  by  atmosphere 
and  climate,  and  marshy  emanations  be  the  principal 
and  most  striking  cause,  China  will  remove  the  whole 
disease  in  a  very  short  time,  especially  if  the  fever 
have  the  character  of  an  intermittent.  If,  on  the  con- 
trary, the  rheumatic  symptoms  should  be  the  most 
prominent,  a  few  doses  of  Aconite  will  be  found  suffi- 
cient to  cure  the  disease.  If  Aconite  should  not  suf- 
fice, or  if  it  should  not  be  indicated,  Chamom.,  Rhus  or 
Pulsat.,  would  be  the  best  remedies,  especially  if  the 
stools  consist  of  blood-streaked  mucus.  Other  reme- 
dies may  likewise  be  indicated.  (See  the  remedies  for 
catarrhal  and  rheumatic  fevers.) 

The  pure  inflammatory,  or  the  bilious  inflammatory, 
dysentery,  sets  in  without  any  precursory  symptoms ; 
it  is  characterized  by  all  the  symptoms  of  a  local  in- 
flammation. The  fever  is  a  synocha ;  it  sets  in  with 
a  violent  chill,  followed  by  a  dry,  burning  heat,  with 
great  thirst,  dry  tongue  and  skin,  and  fiery  urine.  The 
local  symptoms  of  this  kind  of  dysentery  are  as  clear- 
ly marked,  and  are  very  much  like  those  of  enteritis  ; 
both  in  dysentery  and  enteritis  the  abdomen  is  very 
sensitive  to  the  touch,  hot  and  distended,  the  patient 


DYSENTERIC    FEVERS.  207 

is  tormented  with  retching,  vomiting  of  the  ingesta, 
and  coldness  of  the  extremities. 

Inflammatory  dysentery  is  very  rare,  sometimes 
sporadic,  but  scarcely  ever  epidemic;  it  prevails  most- 
ly at  the  end  of  summer  and  the  beginning  of  autumn, 
when  the  days  are  hot  and  the  nights  cool. 

The  first  thing  we  have  to  attend  to  in  the  treatment 
of  inflammatory  dysentery,  is  to  remove  the  synochal 
fever,  which  we  accomplish  by  means  of  a  few  doses 
of  Aconite.  This  remedy  is  frequently  sufficient  to 
subdue  the  whole  disease.  If  the  disease  should  not 
be  subdued  entirely,  Belladonna  has  to  be  used. 
To  confirm  our  assertion  we  will  mention  the  symp- 
toms of  the  disease  more  in  detail.  Without  dwelling 
upon  the  febrile  symptoms  themselves,  which  have 
been  described  with  sufficient  completeness,  under  the 
head  of  synocha,  we  will  at  once  proceed  to  treat  of 
the  local  affection,  premising  that  Belladonna  deserves 
consideration  if  the  dysenteric  patient  be  of  a  pletho- 
ric constitution,  and  have  a  lively,  ardent  tempera- 
ment. The  exacerbation  commences  in  the  afternoon 
and  lasts  until  midnight,  when  the  fever  remits  ;  never- 
theless the  patient  is  prevented  from  sleeping  by  a  vio- 
lent restlessness,  and  a  great  desire  for  cold  drinks  and 
baths.  There  are  moments  when  the  patient  is  de- 
lirious, especially  on  waking  from  a  light  slumber  ; 
his  face  is  then  red,  and  the  head  hot ;  gradually  he 
falls  into  a  whining  mood,  which  cannot  be  subdued 
except  by  emphatic  remonstrances,  or  which  alter- 
nates with  a  firm  resolution  to  jump  out  of  the  bed, 
and  to  look  for  the  chamber.  The  tongue  is  lined 
with  a  whitish  fur ;  the  tip,  which  is  not  coated,  in- 
clines to  be  dry ;  the  patient  has  lost  all  appetite,  or 
has  a  positive  aversion  to  food  ;  the  pains  in  the  bow- 
els are  either  spasmodic  and  colicky,  or  else  cutting- 
burning,  the  abdomen  is  somewhat  distended  in  the 
umbilical  region,  there  is  a  constant  urging  for  stool, 
and  small  discharges  of  a  bloody  mucus. 

In  other  cases  Nux  or  Mercurius  is  indicated.  Nux 
is  indicated  by  discharges  of  a  sanguineous  mucus, 
mixed  with  single  hard  lumps  of  feculent  matter,  and 


208  DYSENTERIC    FEVERS. 

accompanied  with  violent  cutting  in  the  umbilical  re- 
gion, and  pressing  in  the  rectum.  Merc,  is  a  princi- 
pal remedy  when,  after  the  removal  of  the  inflamma- 
tory symptoms,  frequent  discharges  of  bloody  mucus, 
or  liquid  feculent  matter,  remain,  accompanied  with 
cutting  and  tenesmus,  which  causes  burning  and  sore- 
ness of  the  anus ;  every  evacuation  is  preceded  by  a 
cold  sweat  in  the  face,  as  from  anguish  and  excessive 
uneasiness. 

§  67.  The  gastric  dysenteries,  together  with  the  ca- 
tarrhal-rheumatic,  are  the  most  frequent,  and  are  cha- 
racterized by  the  fetid  smell  and  putrid  bilious  nature 
of  the  evacuations.  According  to  authors  there  exists 
in  the  first  place  a  bilious  dysentery,  which  is  apt  to 
occur  when  the  nights  are  cold  and  the  days  hot,  and 
which  sets  in  with  all  the  symptoms  of  a  bilious  fever  ; 
the  stools  are  frequent,  consisting  from  the  commence- 
ment of  a  fetid,  green  or  brown  bile  ;  colic  and  tenes- 
mus are  very  violent,  accompanied  with  great  restless- 
ness and  oppression  of  breathing.  The  bilious  dysen- 
teries resemble,  to  a  certain  extent,  the  inflammatory 
variety ;  spontaneous  vomiting  affords  relief.  They 
occur  most  generally  as  an  epidemic  disease,  towards 
the  end  of  very  hot  summers,  and  at  the  commence- 
ment of  the  fall,  after  a  continuous  heat. 

In  this  variety  likewise,  the  treatment  ought  to  com- 
mence with  the  removal  of  the  inflammatory  symp- 
toms by  means  of  Aconite,  after  which  the  specific 
remedy  in  this  variety,  Mercurius  corrosivus,  may  be 
exhibited. 

This  remedy  is  indicated  by  a  succession  of  small 
muco-sanguinolent  evacuations,  continuing  day  and 
night,  with  constant  cutting  pain  in  the  bowels,  and 
an  insupportably  painful  tenesmus  in  the  rectum ;  or 
when  the  stools  are  mixed  with  fetid  green  or  brown 
bile ;  the  patient  has  lost  all  appetite,  suffers  with  an 
unquenchable  thirst,  his  tongue,  the  edges  of  which 
have  a  whitish  coating,  inclines  to  dryness,  he  feels 
anxious,  hot,  and  is  deprived  of  sleep  in  consequence  ; 
the  pulse  is  small,  feeble,  frequent. 

The  Colocynthis  dysentery  has  the  following  symp- 


DYSENTERIC    FEVERS.  209 

toms.  The  greenish-yellow  and  frequent  evacuations, 
consisting  of  a  watery  slime  streaked  with  pure  blood, 
are  accompanied  with  the  most  violent  colicky  pains 
in  the  region  of  the  hypogastrium  ;  these  pains  disap- 
pear with  every  evacuation,  and  the  tenesmus  is  en- 
tirely wanting.  The  appetite  is  not  entirely  lost,  but 
all  desire  to  eat  is  counteracted  by  the  offensive,  bit- 
ter taste  in  the  mouth ;  there  is  a  great  desire  for 
drinks  without  much  thirst ;  every  time  the  patient 
eats  or  drinks  the  colic  and  the  evacuations  are  ex- 
cited again.  The  temperature  of  the  skin  is  moderate, 
the  pulse  is  full  and  not  too  quick. 

Bilious  dysentery,  especially  when  epidemic,  may 
assume  a  form  requiring  the  use  of  Colchicum  autum- 
nale.  This  remedy  is  extremely  valuable  in  dysente- 
ry consisting  of  a  mere  white  mucus,  with  violent 
spasms  in  the  sphincter  ani,  these  spasms  setting  in 
frequently  when  there  is  no  evacuation,  in  which  case 
the  patient  experiences  slight  chills  over  the  back. 
Bilious  vomiting  leaving  a  bitter  taste  in  the  throat, 
and  an  aversion  to  food,  generally  belongs  to  the  Col- 
chicum dysentery.  The  perspiration  which  exists  in 
the  commencement  of  the  disease,  disappears  after- 
wards, and  the  pulse  becomes  accelerated  and  small. 

Veratrum  has  been  employed  by  us  several  times 
with  success,  where  portions  of  faeces  were  distinctly 
seen  in  the  watery-sanguineous,  flocculent  discharges. 
These  evacuations  were  more  frequent  at  night  than 
in  the  day-time ;  they  were  accompanied  and  succeed- 
ed by  colic,  but  not  so  much  tenesmus ;  chills  were 
likewise  present.  Veratrum  is  still  more  suitable 
when  the  dysentery  is  accompanied  with  vomiting  of 
the  ingesta,  great  debility,  as  if  one  could  not  support 
one's-self,  bland  delirium,  and  lentescent  fever.  It  is 
of  the  utmost  importance  to  repeat  the  remedy  in  that 
disease,  provided  the  remedy  which  had  been  selected 
was  homoeopathic  to  the  symptoms. 

In  pituitous  dysentery  the  inflammatory  character 
disappears  more  and  more ;  the  phenomena  denoting 
an  irritation  of  the  mucous  membrane  become  more 
and  more  prominent,  establishing  a  similarity  between 


210  DYSENTERIC    FEVERS. 

the  dysenteric  disease  and  a  mucous  fever.  The  pre- 
cursory symptoms  of  mucous  dysentery  are  the  same 
as  those  of  a  mucous  fever.  The  disease  itself  is 
slower  than  any  other  kind  of  dysentery,  if  the  reme- 
dies be  not  well-chosen ;  the  febrile  symptoms,  as  well 
as  the  local  affection,  are  indeed  violent,  but  not  as 
violent  as  in  the  other  varieties  of  dysentery ;  the  fre- 
quent evacuations  from  the  bowels  are  without  colour 
or  smell. 

This  kind  of  dysentery  is  principally  occasioned  by 
catching  cold  in  the  damp,  wet,  and  cold  fall  weather ; 
hence  it  is  that  the  pituitous  or  white  dysentery  occurs 
more  frequently  as  an  epidemic  and  endemic,  than  as 
a  sporadic  disease  ;  it  prevails  in  October  and  Novem- 
ber, whereas  bilious  dysentery  is  more  prevalent  in 
August  and  September. 

Mucous  dysenteries  are  cured  the  most  easily  in  the 
precursory  stage ;  Mercurius,  Pulsatilla,  and  Dulca- 
mara being  the  principal  remedies.  Pulsatilla  is  fre- 
quently the  best  remedy  even  when  the  dysentery  has 
become  fully  developed.  Colchicum  autumnale  seems 
to  correspond  principally  to  mucous  dysenteries  ;  Merc, 
corr.  is  likewise  an  excellent  remedy  for  that  disease, 
if  the  stools  be  mixed  with  blood.  The  preparations 
of  Sulphur  ought  to  be  resorted  to  after  the  character- 
istic symptoms  of  dysentery  have  been  greatly  sub- 
dued, but  would  not  yield  beyond  a  certain  point,  or 
became  worse  again  after  a  temporary  improvement 
had  been  effected.  In  many  cases  of  that  description 
Acidum  sulph.  will  suffice,  unless  Sulphur  should  be 
more  specifically  indicated.  It  is  principally  adapted 
to  those  forms  of  dysentery  where  the  symptoms  are 
more  violent  in  the  night,  and  the  patient  passes 
blood,  mucus  and  pus,  accompanied  with  fever,  loss  of 
appetite,  cutting  colic,  and  a  desire  to  lie  down ;  the 
colic  is  frequently  so  violent  that  it  causes  sickness  of 
the  stomach,  and  the  patient  is  drenched  with  sweat. 
The  fever  consists  of  a  dry  heat,  generally  flushes  of 
heat,  without  any  particular  thirst.  Hepar  sulph. 
comes  next  to  Acidum  sulph. 

Aloes  is  undoubtedlv  one  of  those  remedies  which 


DYSENTERIC    FEVERS.  211 

will  prove  valuable  in  dysentery,  inasmuch  as  it  pos- 
sesses the  peculiarity  of  causing  violent  colic,  with 
bloody  stools. 

Ipecacuanha  is  useful  in  gastric  dysenteries,  in  the 
commencement  of  the  attack,  if  the  diarrhosa  be  ac- 
companied with  vomiting,  and  a  pinching  pain  in  the 
abdomen. 

Cantharides  is  indicated  when  the  patient  discharges 
a  white  mucus  from  the  bowels,  which  looks  as  if  it 
had  been  scraped  off  the  bowels ;  the  discharges  are 
accompanied  with  burning  pains  in  the  abdomen  and 
bowels,  occasioning  moaning  and  lamentations.  The 
fever  is  generally  very  violent,  burning,  with  dryness 
of  the  mouth,  thirst,  anxiety,  and  a  small,  hard,  and 
intermittent  pulse. 

Capsicum  deserves  especial  consideration  after  the 
violent  cutting  pains  have  been  removed,  and  an  in- 
tensely painful  feeling  of  pressure  remains  in  the 
region  of  the  stomach  and  duodenum,  accompanied 
with  discharges  of  a  greenish  frothy  matter,  or  flocks 
of  bloody  mucus ;  the  pulse  is  full,  strong,  and  par- 
ticularly frequent  from  evening  until  midnight. 

Carbo.  veg.  ought  likewise  to  be  recommended  for 
dysenteric  discharges  of  bloody  mucus  ;  it  ranks  next 
to  Cantharides,  as  regards  the  pain  in  the  abdomen, 
especially  about  the  umbilicus,  and  is  distinguished 
from  Cantharides  by  the  burning  pain  being  accompa- 
nied with  cutting.  Carbo  veg.  is  indicated  in  dysen- 
tery when  the  following  group  of  symptoms  occurs,  af- 
ter the  evacuation  from  the  bowels :  pushing  in  the 
direction  of  the  small  of  the  back  and  the  bladder, 
with  pressure  on  the  rectum,  and  burning  in  that  part ; 
feeling  of  emptiness,  want  of  tonicity,  anxiety,  tremu- 
lous weakness  ;  frequent  attacks  of  burning  heat,  es- 
pecially at  night,  disturbing  sleep. 

A  distinguished  remedy  in  that  variety  of  dysentery 
is  Rhus  tox.  It  is  especially  suitable  when  the  disease 
is  slow  to  get  well,  and,  in  spite  of  some  slight  im- 
provement, all  the  original  symptoms  are  yet  remain- 
ing ;  when  the  patient  appears  weak  and  falling  away, 
the  plasticity  of  the  blood  is  greatly  diminished,  the 


212  DYSENTERIC    FEVERS. 

organic  activity  threatens  to  become  extinct,  and 
typhoid  symptoms  set  in.  The  symptoms  indicating 
Rhus  being  very  various,  we  content  ourselves  with 
barely  mentioning  that  fact,  leaving  the  reader  to 
compare  the  symptoms  of  the  case  with  those  record- 
ed in  the  Materia  Medica. 

Next  to  Rhus,  Staphysagria  deserves  to  be  men- 
tioned. It  is  employed  in  dysentery  with  frequent  dis- 
charges of  a  yellow  mucus,  tenesmus,  cutting  pain  in 
the  abdomen,  the  whole  body  feels  painful  as  if  bruised, 
and  the  muscular  tone  is  greatly  diminished. 

Nitri  acidum  is  probably  the  best  remedy  when 
there  is  a  constant  pressing  in  the  rectum  without  any 
evacuation  ;  or  else  the  patient  evacuates  mere  mucus, 
after  which  the  tenesmus  continues,  followed  by  a  pain- 
ful tension,  with  pressure  in  the  whole  of  the  head, 
constant  heat,  great  dryness  in  the  throat,  violent 
thirst,  and  an  unequal  intermittent  pulse. 

Plumbum  corresponds  to  dysentery  of  the  most  vio- 
lent kind,  the  patient  discharging  nothing  but  blood  ; 
the  accompanying  symptoms  are,  violent  fever,  severe 
cutting  in  the  stomach  and  abdomen,  burning  in  the 
anus  during  the  evacuation,  and  continuation  of  the 
tenesmus  even  after  stool. 

The  worm  dysentery  is  different  from  the  worm 
fever  and  the  worm  colic  ;  the  symptoms  vary  sudden- 
ly, and  seem  dangerous  without  any  real  danger  be- 
ing present.  That  kind  of  dysentery  can  only  be 
looked  upon  as  a  secondary  affection,  which  must 
necessarily  disappear  with  the  cure  of  the  primary 
worm  disease.  The  term  "  dysentery  "  is  not  a  proper 
appellation  for  that  disease,  inasmuch  as  the  charac- 
teristic symptoms  of  dysentery  are  not  sufficiently 
prominent ;  it  might  be  considered  a  sort  of  dysenteric 
diarrhoea.  As  regards  the  treatment,  we  refer  to  our 
remarks  on  worm  fever. 

For  the  sake  of  completeness,  we  will  likewise 
mention  the  putrid  variety  of  dysentery.  According 
to  authors,  it  is  both  secondary  and  primary.  The 
secondary  variety  results  from  the  slow  development 
of  pituitous  dysentery  ;  its  existence  is  recognized  by 


DYSENTERIC    FEVERS.  213 

great  debility,  profuse,  colliquative,  and  excessively 
fetid  stools;  dry,  brown,  cracked  tongue,  extremely 
rapid  and  scarcely  perceptible  pulse. 

A  secondary  putrid  dysentery  cannot  possibly  occur 
under  homoeopathic  treatment,  unless  the  physician 
be  utterly  incompetent.  If  a  pituitous  dysentery  be 
properly  treated,  it  ought  to  improve  four  or  five  days 
after  the  treatment  has  commenced,  it  ought  never  to 
last  three  weeks,  or  even  a  fortnight,  as  is  stated  in 
pathological  books. 

A  primary  putrid  dysentery  has  all  the  symptoms  of 
an  epidemic  and  contagious  malady.  Beside  the 
pathognomonic  symptoms  of  dysentery,  there  is  this 
peculiarity,  that  its  phenomena  set  in  with  the  utmost 
rapidity  and  violence,  and  with  a  considerable  sinking 
of  strength.  At  first  a  putrid  dysentery  has  an  in- 
flammatory character  ;  the  stools  are  not  so  frequent 
as  afterwards,  but  are  so  much  more  painful,  and  are 
accompanied  with  violent  colic.  At  this  stage  of  the 
disease  it  ought  to  be  treated  like  an  inflammatory 
dysentery.  If  the  symptoms  of  a  local  affection  of  the 
intestines  should  become  more  prominent ;  if  decayed, 
fetid  masses  should  be  discharged  from  the  bowels 
without  any  very  great  pain,  and  sometimes  involun- 
tarily ;  if  the  patient  should  frequently  vomit  bile  or 
mucus,  and  should  complain  of  great  loathing,  and  a 
putrid  taste  and  smell ;  if  the  symptoms  of  a  general 
status  putridus  should  develope  themselves,  such  as  : 
hemorrhages,  aphthae,  petechiae,  blue  spots  and  serous 
vesicles  on  the  skin,  a  burning  hot  skin  ;  turbid,  floccu- 
lent  urine,  having  a  cadaverous  smell ;  sunken,  stupid 
expression  of  countenance,  indifference  to  surrounding 
things,  soporous  condition,  etc.,  Nux,  Arsenic,  Petro- 
leum, Carbo  veg.,  Acid  sulp.  and  nitr.,  Kreosot,  China, 
are  the  best  remedies  to  be  used ;  these  remedies, 
especially  Sulphur,  Nitric  Acid,  and  Petroleum,  ought 
likewise  to  be  employed  when  the  disease  improves 
but  slowly  in  spite  of  the  best  selected  remedies,  or 
when  it  threatens  to  get  worse  again  after  an  im- 
provement of  some  days  ;  in  one  word,  when  the  dis- 
ease is  protracted,  which  is  usually  the  case  in  persons 


214  DIARRHCEA. 

with  a  depressed  vitality,  debilitated,  nervous,  sensi- 
tive, scrofulous,  and  disposed  to  chronic  maladies. 

In  this  disease  the  diet  is  of  the  utmost  importance. 
Errors  in  diet  may  be  extremely  detrimental  to  the 
patient.  The  patient  ought  to  abstain  from  fruit  and 
green  vegetables,  both  during  and  for  some  time  after 
the  malady.  Slimy  soups  and  beverages  are  the  most 
suitable  nourishment,  especially  salep,  oatmeal-gruel, 
and  the  white  of  an  egg  with  sugar  and  water ;  and 
lastly,  boiled  water,  which  agrees  with  the  patient 
better  than  anything  else,  and  aids  in  restoring  the 
process  of  sanguification  to  its  normal  standard.  We 
know  from  pathological  anatomy  that  the  blood  under- 
goes a  morbid  change  in  dysentery,  which,  in  its  turn, 
favours  the  development  of  the  disease. 

§  68.  If  typhoid  symptoms  should  be  developed  in 
the  course  of  a  pituitous  or  putrid  dysentery,  which 
happens  in  the  colliquative  stage,  the  same  rules  apply 
which  have  been  laid  down  for  the  treatment  of  a 
secondary  putrid  dysentery.  A  typhoid  dysentery 
never  exists  as  a  primary  disease,  and  has  to  be  treated 
with  remedies  which  correspond  both  to  the  typhoid 
and  dysenteric  symptoms.  (See  the  chapters  on 
typhoid  fevers.) 

§  69.  Diarrhoea. 

Diarrhoea  is  generally  a  symptom  of  some  more 
general  disease,  or  a  salutary  crisis.  However, 
diarrhoea  may  likewise  occur  as  a  primary  disease  of 
the  reproductive  system,  accompanied  with  fever. 

The  essential  character  of  diarrhoea  is  an  increased 
'and  looser  discharge  from  the  bowels,  the  colour  being 
more  or  less  different  from  the  natural.  It  is  frequently 
preceded  by  the  precursory  symptoms  of  a  gastric 
affection.  Colic  is  not  always  present ;  sometimes, 
however,  it  is  very  violent  (diarrhoea  torminosa)  ; 
tenesmus  is  scarcely  ever  present. 

The  disease  lasts  from  a  few  days  to  several  months, 
and  even  years.  The  discharges  vary  likewise,  fecu- 
lent, fluid,  mucous,  bilious,  purulent,  bloody.  Diarrhoea 
may  be  without  any  danger,  getting  well  of  itself,  or 


DIARKHCEA.  215 

it  may  become  dangerous  by  its  continuance,  or  danger 
may  actually  be  present  when  diarrhoea  sets  in. 

A  diarrhoea  which  is  not  manifestly  dangerous 
ought  not  to  be  arrested*  suddenly ;  danger  may  be 
supposed  to  exist  when  the  discharges  are  quite 
watery  (although  this  is  not  always  a  symptom  of 
danger),*  and  great  debility  after  every  evacuation, 
sometimes  amounting  to  syncope. 

The  selection  of  the  remedy  depends  upon  the  form 
and  nature  of  the  discharges.  We  distinguish  the  fol- 
lowing kinds  of  diarrhoea : — 

Diarrhoea  stercoralis,  being  generally  a  consequence 
of  overloading  the  stomach  with  heavy,  undigestible 
fat,  rancid,  sour  food  and  drink.  It  is  preceded  by 
offensive  eructations,  aversion  to  food,  colic,  distention 
and  tightness  of  the  stomach  and  abdomen,  nausea, 
and  sometimes  vomiting ;  after  these  symptoms  have 
set  in,  a  quantity  of  flatulence  is  generally  emitted, 
accompanied  with  loose,  fetid,  papescent  stools,  some- 
times corroding  the  anus  and  causing  a  burning  and 
pain  in  that  part. 

As  regards  the  treatment,  the  same  rules  apply 
which  have  been  laid  down  for  the  treatment  of  the 
precursory  symptoms  of  gastric  and  bilious  fevers. 
This  kind  of  diarrhoea  gets  •well  of  itself,  as  nature  is 
competent  to  remove  the  noxious  substances.  In  some 
cases  a  cup  of  black  coffee  will  have  to  be  used  for 
that  purpose,  or,  if  this  should  not  be  sufficient,  one  of 
the  above-mentioned  remedies  may  be  employed. 

Diarrhoea  aquosa  serosa  is  a  second  form  of  diarrhoea. 
This  diarrhoea  is  occasioned  by  a  cold  either  of  the  feet 
or  abdomen,  and  is  sometimes  a  prevailing  or  even 
epidemic  disease  in  the  latter  part  of  summer,  or  in 
the  fall  season.  It  is  sometimes  accompanied  with  a 
lancinating  pain  in  the  bowels  and  spasms  in  the  ab- 
domen, retching,  and  nausea.  The  discharges  take 
place  in  rapid  succession,  they  are  watery,  serous, 
have  very  little  smell,  sometimes,  however,  they  are 

*  I  am  now  treating  a  gentleman  who  has  been  suffering  with  watery 
diarrhoea  for  the  last  six  years,  from  three  to  eight  discharges  a-day.  He  is 
as  rtrong  and  healthy  as  any  man. — HEMFTL. 


216  DIARRHCBA. 

bilious ;  every  discharge  is  accompanied  with  a  new 
and  violent  attack  of  colic.  The  diarrho3a  of  children, 
occasioned  by  dentition,  is  of  a  similar  kind,  it  is  some- 
times accompanied  with  heat,  fever,  and  loss  of  appe- 
tite. If  such  diarrhoeas  should  be  violent,  and  last  a 
long  while,  serum  and  even  fibrin  are  passed,  occasion- 
ing sudden  prostration. 

Dulcamara,  frequently  repeated,  is  the  best  remedy 
for  most  cases  of  this  form  of  diarrhoea,  when  it  takes 
place  in  the  summer  season,  consists  of  green  or  yel- 
low mucus,  has  a  sour  smell,  the  evacuations  being 
preceded  by  colic,  followed  by  debility  and  remission 
of  the  pain,  and  generally  taking  place  in  the  evening. 
If  the  diarrhoea  be  not  so  much  accompanied  with 
pain  in  the  bowels,  but  debilitating  ;  if  it  be  a  kind  of 
lienteria,  where  the  evacuations  take  place  shortly 
after  a  meal,  and  especially  at  night,  with  or  without 
cutting  in  the  bowels  ;  if  they  contain  undigested  food, 
China  will  prove  serviceable  ;  in  many  cases  Bryonia 
will  have  to  be  given,  especially  if  the  diarrhoea  have 
been  occasioned  by  a  cold,  if  the  evacuations  occur 
almost  involuntarily,  have  a  fetid  smell  and  brown 
colour,  if  they  be  liquid  as  in  infants,  accompanied 
with  flatulence  or  fermentation  in  the  bowels.  This 
kind  of  diarrhoea  is  sometimes  controlled  by  Rheum, 
especially  when  it  affects  children  of  any  size,  during 
dentition  or  afterwards,  they  look  pale,  grumble  and 
quarrel  a  good  deal,  with  heat  all  over ;  the  evacua- 
tions are  feculent,  papescent,  smell  sour,  and  are  ac- 
companied with  a  constrictive  pain  in  the  bowels. 
Mercurius  solubilis  will  afford  help  if  the  discharges 
of  green  mucus  should  be  accompanied  with  a  pinch- 
ing and  cutting  pain,  and  should  be  so  acrid  that  they 
cause  a  burning  and  itching  of  the  anus ;  the  rectum 
sometimes  protrudes,  and  the  stools  are  streaked  with 
blood. 

Chamomilla  is  the  surest  remedy  against  diarrhcEa 
which  occurs  during  dentition  and  is  occasioned  by  a 
cold ;  it  is  generally  watery,  green  or  like  chopped 
eggs,  smells  like  putrid  eggs  and  is  accompanied  with 
pinching  colic.  If  the  diarrhosa  should  set  in  with 


DIARRHOEA.  217 

sudden  prostration  and  a  violent  cutting  pain  in  the 
bowels,  the  surest  remedy  is  a  small  dose  of  Arsenic. 
Many  homoeopathic  physicians  recommend  Arsenic  as 
the  best  remedy  for  diarrhoea  from  dentition  ;  it  seems 
however  that  latterly  the  tincture  of  Sulphur  has  been 
employed  with  more  success  than  Arsenic.  Charac- 
teristic indications  for  Pulsatilla  are  the  greater  fre- 
quency of  the  diarrhoea  at  night,  especially  before 
midnight,  or  immediately  after  getting  up  in  the  morn- 
ing, the  discharges  being  watery,  green,  bilious  ;  Rhus 
is  indicated  when  the  jelly-like,  yellow,  and  still  more 
or  less  feculent  discharges  take  place  only  after  mid- 
night and  are  preceded  by  violent  colic  which  dis- 
appears after  the  evacuation.  Calcarea  acetica, 
several  doses,  has  been  successfully  employed  by  some 
homoeopathic  physicians  against  that  kind  of  diarrhoea, 
if  it  was  of  long  standing,  or  a  watery,  acrid  diarrhoea, 
corroding  the  anus,  and  accompanied  with  vomiting  of 
the  ingesta  soon  after  a  meal,  Ferrum  metallicum  is  an 
excellent  remedy.  Acidum  phosp.  and  Phosphorus  are 
still  more  important,  when  the  disease  is  one  of  long 
standing.  These  two  remedies  are  particularly  adapt- 
ed to  chronic,  painless,  half-liquid  diarrhoeas,  under- 
mining the  general  health  but  slowly ;  or  to  diarrhoeas 
occurring  from  suppressed  scarlatina,  or  to  such  as 
occasion  a  general  nervous  weakness  with  excessive 
emaciation. 

A  third  kind  of  diarrhoea  is  the  diarrhoea  biliosa. 
This  kind  of  diarrhoea  is  a  little  more  complicated 
than  the  two  preceding  varieties.  It  is  generally 
occasioned  by  moral  emotions,  anger,  chagrin,  some- 
times by  catching  cold  in  hot  and  damp  weather ;  this 
frequently  makes  it  an  endemic  or  epidemic  disease. 
Its  accompanying  symptoms  are:  want  of  appetite, 
bitter  taste,  yellowish  complexion,  coating  of  yellow 
mucus  on  the  tongue,  bitter  and  disagreeably  sour 
eructations,  aversion  to  food,  nausea,  and  sometimes 
vomiting  of  bile  ;  the  evacuations  are  bilious,  yellow, 
green,  and  are  accompanied  with  violent  colic.  The 
diarrhoea  from  dentition  is  sometimes  characterized  by 
similar  symptoms ;  in  this  case  the  sour-smelling, 
10 


218  DIARRH(EA. 

greenish  stools  do  not  always  depend  upon  an  effusion 
of  bile,  but  upon  acidity  in  the  primae  vise  ;  they  fre- 
quently have  a  chopped  appearance  or  look  like 
stirred  eggs ;  in  some  cases  the  anus  is  corroded  by 
the  stools. 

The  remedies  for  bilious  diarrhoea  are  the  same 
which  have  been  indicated  §  40,  and  the  following. 
The  diarrhoea  which  is  occasioned  by  acidity  in  the 
primae  vise,  and  is  most  frequently  met  with  in  children, 
is  cured  by  Chamomile  or  Rheum.  Sometimes  such  a 
sour-smelling  diarrhoea  becomes  chronic  ;  in  such  a 
case  Magnes.  carb.  will  remove  the  trouble  in  a  very 
short  while.  If  the  anus,  genital  organs,  and  inner 
surface  of  the  thigh  should  be  very  sore,  and  if  the 
whole  body,  but  especially  the  thighs,  should  be  cover- 
ed with  a  miliary  eruption,  Sulphur  is  the  best 
remedy.  If  the  children  should  be  still  at  the 
breast,  the  dose  had  better  be  given  to  the  mother  or 
nurse,  recommending  a  strict  homoeopathic  diet.  This 
diet  is  likewise  necessary,  .when  the  child  is  brought 
up  without  the  breast  or  is  already  weaned.  In  very 
many  cases  the  little  being  is  stuffed  with  pernicious 
things  or  an  excessive  quantity  of  food,  pap,  etc.,  to 
keep  it  quiet.  In  cases  where  Chamomilla  is  indicated, 
the  physician  ought  to  inquire  very  carefully  whether 
Chamomile-tea  had  been  given  ;  for  the  diarrhoea  fre- 
quently arises  from  an  abuse  of  that  drug.  In  that 
case  the  symptoms  ought  to  be  antidoted  by  Coffea  or 
Pulsatilla  before  another  remedy  is  given. 

Besides  the  remedies  already  mentioned  we  refer  to 
Mercurius,  Hepar  sulp.,  Sepia,  Calcarea,  and  Gra- 
phites. We  have  seen  this  diarrhoea  in  children  several 
times,  who  looked  like  a  piece  of  raw  flesh  all  over 
the  body,  lamented  a  good  deal  at  night,  and  were 
prevented  from  sleeping  by  the  pain.  This  condition 
depends  generally,  but  not  exclusively,  upon  syphilis  in 
the  parents.  There  is  no  better  remedy  for  that  group  of 
symptoms  than  Mercurius  ;  this  either  effects  a  cure  or 
modifies  the  symptoms  so  that  they  will  yield  to  Hepar 
s.,  Sulp.,  or  Graphites. 

The  remedies  which  we  have  indicated  in  the  pre- 


DIARRH03A.  219 

ceding  paragraphs,  but  especially  Calcarea,  are  es- 
pecially adapted  to  such  diarrhoeas  when  occurring  in 
scrofulous  patients  ;  the  secondary  symptoms,  which, 
however,  are  not  always  very  prominent,  will  point 
more  distinctly  to  one  or  the  other  of  those  remedies. 

A  fourth  class  of  diarrhoea  is  the  diarrhoea  mucosa, 
pituitosa.  This  diarrhoea  sometimes  arises  from  a  mis- 
managed watery  or  feculent  diarrhoea.  Or  it  may  be 
occasioned  by  a  cold  in  damp,  wet  and  cold  fall-wea- 
ther, and  in  low  and  marshy  regions  ;  when  such 
causes  prevail,  the  diarrhoea  may  become  epidemic  or 
endemic.  Weakly,  nervous,  dyspectic  persons  are 
most  easily  affected.  The  disease  is  ushered  in  by  dis- 
tention  and  hardness  of  the  abdomen,  pressure  and 
feeling  of  repletion  in  the  abdomen,  flatulence,  loss  of 
appetite,  slimy  coating  of  the  tongue,  etc.  The  dis- 
charges have  various  colours,  generally  they  are  slimy, 
and  sometimes  streaked  with  blood.  They  are  de- 
bilitating, and  induce  emaciation  unless  soon  arrested. 
This  kind  of  diarrhoea  is,  in  most  instances,  a  conse- 
quence of  existing  affections,  especially  of  mucous 
fevers. 

As  a  general  rule,  mucous  diarrhoeas  are  treated 
like  mucous  fevers.  It  is  a  remarkable  fact  that  such 
diarrhoeas,  together  with  their  accompanying  symp- 
toms, generally  correspond  to  Pulsatilla,  especially  if 
the  colour  of  the  stools  vary.  If  the  diarrhoea  should 
be  greatly  debilitating,  Colocynthis  may  be  given.  If 
the  evacuations  should  be  slimy,  green,  sanguineous, 
accompanied  bytenesmus,  Merc.  sol.  is  the  remedy.  If 
the  disease  should  be  one  of  long  standing,  Petroleum 
will  sometimes  cure  it,  provided  it  corresponds  to  the 
secondary  symptoms  ;  Acidum  phosp.  or  Phosporous 
are  sometimes  the  best  remedies.  According  to  Dr. 
Gross,  the  best  remedy  in  painless  diarrhoea  is  Ferrum 
metallicum.  Lately  Secale  cornutum  has  been  fre- 
quently given  for  mucous  diarrhoea,  especially  when 
the  tongue  was  coated  with  mucus,  and  the  patient 
complained  of  papescent  taste  and  rumbling  in  the 
abdomen.  It  may  be  remarked  that  all  those  reme- 
dies have  to  be  given  repeatedly. 


220  TYPHUS. 

We  do  not  speak  of  diarrhoea  verminosa,  diarrhoea 
sanguinea,  diarrhoea  urinalis,  and  diarrhoea  purulenta ; 
these  are  secondary  affections  which  have  to  be  treat- 
ed in  company  with  the  primary  disease. 

Slimy  kinds  of  food  and  drink,  such  as  sago,  salep, 
rice,  vermicelli,  gruel,  barley,  oatmeal,  etc.,  are  to  be 
recommended  in  this  kind  of  diarrhoea ;  if  the  diarrhoea 
be  chronic  and  yield  only  for  a  few  days  to  the  reme- 
dies which  are  given  for  it,  the  patient  may  eat 
whortleberries,  either  raw,  dried,  or  stewed.  Fresh- 
drawn  milk,  not  boiled,  is  an  invaluable  remedy  for 
diarrhoea  of  children  which  does  not  yield  to  medicine. 

FIFTH     CLASS. 
FEVERS    AFFECTING    PRINCIPALLY    THE    NERVOUS    SYSTEM. 

§  70.  Typhus. 

As  in  synochal  and  erethic  fevers  the  vascular  sys- 
tem is  principally  excited,  so  is  typhus  characterized 
by  great  erethism  of  the  nervous  system,  especially  the 
ganglia  and  brain.  Typhus  is  characterized  by  great 
variability  of  all  the  symptoms,  an  apparent  contra- 
diction between  the  symptoms  themselves,  and  be- 
tween the  symptoms  and  the  disease,  for  instance : 
dryness  in  the  mouth  and  no  thirst ;  no  pain  even  when 
causes  are  at  work  which  tend  to  produce  pain ; 
violent  illness  and  no  great  feeling  of  illness,  the 
patient  asserting  on  the  contrary  that  he  feels  well. 
The  moral  symptoms  are  of  the  utmost  importance 
in  typhus,  as  the  selection  of  a  remedy  frequently  de- 
pends upon  them  exclusively.  It  would  be  a  fruitless 
attempt  to  give  an  accurate  and  never-changing 
description  of  typhus,  which  is  an  assemblage  of  the 
most  varied  phenomena.  In  the  following  chapter  we 
give  a  general  description  of  the  characteristic  symp- 
toms of  typhus,  and  shall  furnish  the  particular  indica- 
tions for  the  remedies  which  are  used  in  typhus,  when 
we  come  to  speak  of  the  varieties  of  that  disease. 
Recently  it  has  been  ascertained  that  the  mucous 
membranes  and  the  lymphatic  glands,  especially  those 
of  the  ileum,  are  the  principal  seat  of  the  disease, 
whence  it  has  been  termed  typhus  abdominalis ;  for- 


TYPHUS.  221 

merly  the  dynamic  character  of  the  disease,  the  de- 
pression of  the  nervous  system  was  principally  con- 
sidered and,  in  accordance  with  that  character,  the 
disease  was  named  febris  nervosa  which  could  now  be 
properly  applied  only  to  typhus  cerebralis.  The  more 
precise  appellation  of  this  fever  has  led  homoeopathic 
physicians  to  the  discovery  of  many  valuable  remedies 
for  typhus,  which  it  might  have  been  difficult  to  dis- 
cover without  the  pathological  seat  of  the  disease 
having  been  first  ascertained  by  post-mortem  examina- 
tion. 

§  71.  General  symptoms  of  typhus  ;  diagnosis. 

There  is  no  violent  chill  in  the  commencement,  but 
slow  chills  alternating  with  heat.  The  brain  and 
nervous  system  are  principally  affected  from  the  com- 
mencement, as  may  be  inferred  from  the  following 
symptoms  :  dulness  and  tightness  of  the  head,  gloomy 
mood,  headache,  vertigo,  sometimes  syncope,  tremb- 
ling, subsequent  delirium,  sopor,  spasms  of  every  kind, 
both  external  and  internal ;  convulsions,  great  debility 
and  prostration  ;  small,  feeble,  soft,  easily  compress- 
ible, moderately  frequent,  sometimes  slow,  very  vari- 
able pulse,  which  does  not  harmonize  with  the  respira- 
tion ;  for  instance,  is  rapid  when  the  breathing  is  calm 
(Hufeland). 

There  are  three  kinds  of  more  or  less  distinct  forms 
of  typhus : 

1 .  Typhus  cerebralis,  affecting  principally  the  brain, 
spinal  marrow,  or  the  nervous  system  generally. 
This  variety  of  typhus  is  principally  characterized  by 
symptoms  which  denote  a  deep  alteration  of  the 
functions  of  those  organs  without  any  inflammation 
being  present  ;  there  will  always  be  delirium,  sopor, 
or  paralysis  of  the  organs  of  sense,  when  the  irritative 
stage — great  hurriedness  in  all  the  movements  and 
manifestations  of  the  senses — has  passed  over.  At 
this  stage  of  the  disease  there  is  the  most  remarkable 
difference  in  the  quantity  of  blood  contained  in  the 
brain  and  spinal  marrow  and  their  membranes,  from 
extreme  congestion  to  anaemia ;  sometimes  those  organs 


222  TYPHUS. 

are  compact  and  tenacious,  sometimes  they  are  inter- 
stitially  distended. 

2.  Typhus  abdominalis,  where  a  portion  of  the  ab- 
dominal organs  is  the  principal  seat  of  the  disease. 
This  variety  contains  a  great  number  of  shades  and 
has  a  slow  course.   The  brain  is  only  gradually  invad- 
ed ;  the  cerebral  disturbance  manifesting  itself  with 
a  certain  rapidity  in  full-grown  persons  only,  where 
the  organs,  which  are  the  principal  seat  of  the  typhus, 
have  attained  a  normal   size  without  showing   any 
striking  changes  in  the  reproductive  functions.     We 
now  know  from  post-mortem  examinations  that  the 
principal  seat  of  the  typhus  abdominalis  is  the  mucous 
membrane  of  the  ileum  which  exhibits  various  forms 
of  degeneration,  congestion,  infiltration,  ulceration,  in- 
duration,  interstitial    distention,   softening,   exanthe- 
matic  spots,  gastro-enteritis,  open  or  cicatrized  ulcers. 
Little  by  little  the  mesenteric  glands  and  the  spleen 
are  likewise  affected,  becoming  considerably  enlarged, 
and  from  the  spleen  the  affection  frequently  extends 
to  the   mucous  membrane  of  the  cul-de-sac   of  the 
stomach. 

3.  Pneumo-typhus,  the  organs  of  the  thoracic  cavity, 
especially  the  lungs,  being  principally  affected.     This 
variety  of  typhus  frequently  sets  in  in  the  shape  of  a 
catarrh,  or  of  an  imperfectly-developed  and  therefore 
not  distinctly  marked  pneumonia  ;  the  heart  and  the 
larger  vessels  are  sometimes   affected.     The  patient 
complains  of  great  anxiety,  hurried,  incomplete,  labor- 
ed breathing,  with  short,  croaking,  exhausting  cough  ; 
the  expectoration  has  a  bad   colour,  is  purulent  and 
blood  streaked  ;  certain  regions  in  the  chest  are  more 
or  less  painful.     A  post-mortem  examination  reveals 
the  following  appearances  :  degeneration  of  the  lungs 
by  inflammation  and  gangrene,  hepatization,  adhesions, 
effusions  in  the  mucous  membrane  of  the  bronchia  and 
the  parenchyma  of  the  lungs  ;  the  heart  is  flaccid,  pale 
or  of  a  dingy-red.     The  diagnosis  is  not  very  difficult. 
The  excessive  prostration,  the  violent  and  universal  ir- 
ritation of  the  sensus  communis,  the  appearances  about 


TYPHUS.  223 

the  head  (the  humming  and  buzzing  about  the  ears)  the 
tendency  of  the  fever  to  become  continuous,  inform  the 
physician  that  the  disease  is  not  a  simple  catarrh  but 
that  there  is  an  approaching  typhus  which  although  it 
may  be  kept  in  check  for  a  time,  will  break  forth  in 
all  its  violence  on  the  seventh  day.  The  physical 
signs  resemble  those  of  croupous  (catarrhal)  pneu- 
monia ;  the  percussion-sound  becomes  more  and  more 
dull ;  auscultation  reveals  crepitation  which,  in  the 
stage  of  hepatization,  is  changed  to  a  consonant  rat- 
tling. 

The  course  of  typhus  is  very  irregular  and  un- 
certain ;  the  precursory  symptoms  sometimes  exist  for 
days,  even  weeks,  such  as  tightness  and  dulness  of  the 
head,  vertigo,  tremulousness  of  the  extremities,  head- 
ache, sleeplessness,  dreams,  even  visions.  Typhus 
may  last  from  21  to  28  days,  and  even  longer ;  the 
convalescence  is  slow  and  the  patient  is  liable  to 
relapses. 

§  72.  Typhus  is  divided  into  varieties  according  to 
its  intensity,  its  type  and  complication.  We  distinguish 
a  typhus  mitior  and  gravior,  a  typhus  continuus  and 
remittens,  a  typhus  simplex,  inflammatorius,  putridus, 
gastricus,  rheumaticus,  catarrhalis.  In  homosopathic 
treatment  such  a  classification  has  no  practical  value, 
as  the  selection  of  the  remedy  depends  upon  the  symp- 
toms of  every  case  in  particular,  not  upon  the  charac- 
teristic symptoms  of  the  genus.  Full-grown  persons 
are  more  liable  to  typhus  than  children  and  old 
people. 

The  remote  causes  of  typhus  are  :  privation  or  bad 
quality  of  the  necessary  food,  (hunger,  famine,  bad 
nourishment)  ;  air  which  has  become  vitiated  by 
crowding  a  number  of  men  into  close  rooms,  or  by 
uncleanliness  ;  depletion  by  venesection,  hemorrhage, 
etc. ;  exhaustion  of  the  nervous  power  by  excessive  ir- 
ritation, excessive  exertions  of  the  body  or  mind, 
venereal  excesses,  excessive  heat,  etc. ;  depressing 
emotions:  chagrin,  sadness,  grief,  care,  disappointed 
love ;  nervous  or  putrid  contagia,  dampness,  cold,  an  at- 
mosphere which  does  not  furnish  sufficient  sustenance 


224 

to  the  vital  forces  and  favours  the  development  of  an 
epidemic  typhus  ;  such  an  atmosphere  arises  from  a 
continuance  of  wet  weather  and  easterly  winds. 

§  73.  The  prognosis  depends  upon  the  form  of  ty- 
phus, the  typhus  in  our  climate  is  less  dangerous  than 
the  pest  or  yellow  fever  ;  also  upon  the  stage  in  which 
we  find  the  fever,  a  typhus  which  has  been  continuing 
for  a  time,  is  more  uncertain  than  an  incipient  one  ; 
upon  the  course,  the  more  regular  the  course,  the 
more  favourable  the  prognosis ;  upon  the  violence  of 
the  symptoms,  constant  delirium,  floccilegium,  subsul- 
tus  tendinum,  constant  sleeplessness,  colliquative  se- 
cretions, sopor,  difficult  swallowing,  are  very  unfa- 
vourable. 

Typhus  generally  terminates  by  some  imperfect 
crisis,  metastasis,  metaschematismus,  miliary  eruption 
(which  may  also  be  one  of  the  symptoms),  furuncles, 
abscesses,  deafness,  blindness,  etc. 

Death  takes  place  by  paralysis  of  the  nerves,  or  by 
some  local  affection,  inflammation  of  the  bowels,  or 
by  colliquation,  putrid  decomposition. 

It  is  very  difficult  to  measure  the  exact  extent  of 
the  danger,  owing  to  the  deceptive  feelings  of  the  pa- 
tient, the  uncertainty,  and  the  variability  of  the  symp- 
toms, and  the  opposition  which  seems  to  exist  between 
the  apparent  symptoms  and  the  internal  condition. 
The  pulse  likewise  cannot  always  be  relied  upon,  in- 
asmuch as  a  rapid  pulse  is  not  always  proportionate 
to  the  intensity,  nor  a  calm  and  regular  pulse  to  the 
unimportance  of  the  disease.  The  urine  indicates  an 
improvement,  if  the  turbid  urine  become  clear,  or  the 
clear  urine  moderately  turbid  ;  if  a  sediment  should 
form  at  the  bottom  of  a  lemon  or  straw-coloured  urine, 
this  is  a  sign  of  recovery.  The  danger  increases  in  pro- 
portion as  the  head  is  more  stupified,  insensible,  sopo- 
rous,  the  patient  feels  well,  the  local  paralysis  spreads 
over  an  increasing  number  of  parts  ;  the  tongue,  for 
instance,  feels  paralyzed  when  talking,  or  when  pro- 
truding it  from  the  mouth  ;  there  is  difficult  deglutition, 
incontinence  of  urine,  involuntary  stool,  violent  con- 
vulsions. The  greatest  danger  occurs  when  the  skin 


TYPHUS.  225 

is  unequally  warm,  dry,  or  else  covered  with  clammy 
sweat,  or  when  a  symptomatic  miliary  eruption,  and 
petechiae,  break  out  upon  the  skin  prematurely.  Col- 
liquative  phenomena  are  likewise  dangerous.  What 
is  remarkable  is,  that  deafness  is  generally  a  good 
sign  (Hufeland). 

§  74.  The  treatment  depends  upon  the  individual 
nature  of  every  case,  and  the  remedies  have  to  be 
chosen  in  accordance  with  the  symptoms.  The  fol- 
lowing remedies  have  proved  efficient  in  the  treat- 
ment of  typhus :  Bryonia,  Bellad.,  Rhus,  Phosphorus, 
Nux,  Aconitum,  Arnica,  Arsenic,  Ignatia,  Acid,  phosp., 
Hyosciamus,  Stramonium,  Chamomilla,  Ipec.,  Carbo 
veg.,  Cina,  Pulsat.,  Cocculus,  Lachesis,  Mercurius, 
Camphor,  Opium,  Hellebore,  Valeriana,  China,  Acid, 
mur.,  Spir.  nitr.  dulcis,  Digitalis,  Secale  cornutum, 
Staphysagria,  Spigelia,  Lycop.,  Natrum  mur.,  Magnes. 
mur.,  and  others. 

Typhus  frequently  commences  as  a  synochal  fever, 
with  congestion  of  the  head  and  chest.  The  slight 
chills  on  the  first  and  second  day,  in  connection  with 
loss  of  appetite,  debility  of  the  limbs,  restless  sleep, 
with  frequent  starting  as  if  in  affright,  the  elevated 
temperature  of  the  skin  shortly  increasing  to  a  sting- 
ing, burning  heat,  with  a  good  deal  of  thirst,  a  full, 
accelerated,  rather  hard,  pulse,  and  the  scanty  secre- 
tion of  urine,  point  to  a  deep-seated  affection,  which 
will  not  get  well  without  the  interference  of  art.  Only 
in  a  very  few  cases  do  we  succeed  in  cutting  the  dis- 
ease short ;  the  difficulty  of  accomplishing  this  is  pro- 
bably owing  to  the  vagueness  and  uncertainty  of  the 
symptoms,  which  make  it  impossible  to  hit  upon  a  cer- 
tain remedy.  Frequently,  however,  the  physician  is 
sent  for  too  late  to  prevent  the  development  of  the  dis- 
ease ;  the  patient  or  his  friends  are  not  sufficiently  ac- 
quainted with  the  nature  of  the  symptoms  to  be  aware 
of  their  dangerous  character. 

If  typhus  should  set  in  with   the   symptoms   of  a 
synocha,  such  as :  violent  dry  heat,  burning  skin,  al- 
ternate redness  and  paleness  of  the  cheeks,  great  ere- 
thism of  the  nervous  system,  restlessness,  moaning, 
10* 


226  TYPHUS. 

tossing  about,  apprehensive" anxiety,  painful  conges- 
tion of  blood  to  the  head,  vertigo,  nightly  delirium, 
dry  cough,  which  racks  the  abdomen :  Aconite  is  to 
be  exhibited,  and  should  be  repeated  as  the  intensity 
of  the  fever  requires.  If  there  should  be  no  abate- 
ment of  the  fever,  or  if  other  dangerous  symptoms 
should  make  their  appearance  during  the  use  of  Aco- 
nite, the  continued  exhibition  of  this  remedy  would  be 
highly  improper,  and  would  involve  an  irreparable 
loss  of  valuable  time. 

Sometimes  Belladonna  is  indicated  at  the  very  com- 
mencement of  the  disease  by  the  following  group  of 
symptoms  :  the  disease  is  occasioned  by  fright  or  cha- 
grin ;  convulsive  twitchings  of  the  limbs  are  present ; 
the  patient  complains  of  constant  uneasiness  in  the 
limbs,  especially  in  the  hands  and  feet,  sometimes  in 
the  head,  inducing  a  constant  movement  of  those 
parts,  and  change  of  position  ;  or  the  disease  sets  in 
with  fainting  turns,  after  which  an  excessive  sensi- 
tiveness and  irritability  of  all  the  organs  remains,  this 
being  the  first  commencement  of  typhus  ;  or  the  fever 
may  commence  with  a  continual  drowsiness,  increas- 
ing to  lethargy,  with  snoring,  during  which  the  counte- 
nance changes  frequently  from  cold  and  pale  to  red 
and  hot,  similar  changes  of  temperature  being  ob- 
served in  other  parts  of  the  body ;  if  the  consciousness 
should  remain  active  during  the  sleep,  the  sleep  is  fre- 
quently disturbed  by  startings  as  if  in  affright,  by 
frightful,  anxious  dreams,  \vith  vivid  fancies,  the  fan- 
cies continuing  in  the  waking  state,  with  inability  to 
collect  one's  senses.  In  the  \vaking  state  we  observe  in 
the  patient  various  disturbances  of  the  mind  and  senses, 
which  do  not  justify  the  expectation  of  a  sudden  dis- 
appearance of  the  symptoms ;  the  patient  is  disposed 
to  whine,  he  is  fearful,  anxious  and  restless,  he  moans, 
groans,  starts  out  of  his  bed,  complains  of  internal 
heat,  with  headache  and  vertigo  ;  or  else  he  is  in- 
different, is  not  disposed  to  talk,  and  is  frequently 
subject  to  illusions  of  the  senses  and  the  fancy. 

As  the  disease  progresses  the  erethic  fever  increases, 
the  delirium  becomes  more  furious,  the  patient  has 


TYPHUS.  227 

visions  in  the  waking  state,  startings  as  in  affright, 
with  internal,  burning  heat,  without  thirst,  distention 
of  the  veins  of  the  head,  violent  throbbing  of  the  arte- 
ries of  the  head,  especially  in  the  forehead  and  temples, 
violent  pressing  pains  in  the  temples,  from  within  out- 
ward, which  become  intolerable  by  movement,  con- 
versation, light,  walking  through  the  room,  and  are  ac- 
companied by  vivid  fancies  and  delirium  ;  the  patient 
stares,  the  whites  of  the  eyes  are  red ;  in  his  rational 
moments  the  patient  complains  of  buzzing  in  the 
ears,  scintillations,  and  blackness  before  the  eyes  ;  the 
lips  and  buccal  cavity  are  dry,  the  tongue  is  red,  burn- 
ing-hot, parched ;  the  appetite  is  gone,  the  patient 
complains  of  a  violent  burning  thirst,  with  difficult 
deglutition,  on  account  of  the  violent  dryness  ;  disten- 
tion of  the  abdomen,  with  sensitiveness  to  the  touch 
and  frequent  small  diarrhoeic  stools.  The  scanty  urine 
is  generally  dark-red,  becomes  turbid,  and  deposits  a 
reddish  sediment.  When  these  symptoms  occur,  re- 
peated doses  of  Belladonna  are  the  best  remedy. 

In  typhus,  with  erethic  congestions  of  the  head, 
Bryonia  is  likewise  a  most  valuable  remedy,  when  the 
following  group  of  symptoms  occurs :  after  a  slight 
cold  the  patient  complains  of  a  pain  as  if  bruised  in 
the  whole  body,  everything  upon  which  he  is  lying  is 
too  hard  for  him  ;  the  beating,  pressing  pain,  in  the 
forehead,  from  within  outward,  is  especially  distress- 
ing to  the  patient  when  looking  up  or  moving  his  eyes  ; 
the  scalp  is  painful  to  the  touch,  and  the  head  burns 
like  fire,  in  spite  of  \vhich  the  forehead  is  sometimes 
covered  with  cold  sweat ;  debility,  weariness  and 
weight  in  the  limbs,  which  obliges  him  to  sit  or  lie 
down,  with  dread  of  the  open  air  ;  the  night's  rest  is 
disturbed  by  erethism  of  the  circulation,  heat  and 
anxiety,  especially  in  the  hours  before  midnight ;  the 
patient  moans  during  sleep,  and  is  waked  by  anxious 
and  frightful  dreams,  which  continue  even  after  waking. 
A  characteristic  symptom  in  the  commencement  of 
the  Bryonia  typhus  is  the  alternation  of  heat  and  chilli- 
ness, the  former  in  the  morning,  the  latter  in  the  after- 
noon, and  on  going  to  bed  ;  the  thirst  is  moderate,  but 


228  TYPHUS. 

there  is  vertigo,  increase  of  headache,  and  excessive 
erethism  of  the  nervous  system.  Gastric  symptoms 
are  manifestly  present ;  the  patient  complains  of  bit- 
terness in  the  mouth,  dryness  and  yellow  coating  of 
the  tongue,  aversion  to  food,  nausea,  with  inclination 
to  vomit,  pressure  and  stinging  in  -the  pit  of  the 
stomach,  sensation  in  the  hypochondria  as  if  they  were 
distended,  difficult  stool. 

As  the  disease  progresses  the  violent  heat  becomes 
permanent,  and  is  accompanied  with  violent  delirium, 
without  the  patient  complaining  much  of  his  illness  ; 
the  distortion  of  the  features,  and  the  grasping  at  the 
head,  are  the  only  signs  of  the  continuance  of  the  vio- 
lent headache  ;  the  continued  moaning,  even  when 
the  patient  is  awake,  points  to  an  approaching  rash, 
which  frequently  breaks  out  in  the  shape  of  a  white 
miliary  eruption,  and  sometimes  in  the  shape  of  pete- 
chias.  The  delirious  talk  of  the  patient  in  most  cases 
turns  about  the  patient's  business,  which  gives  him  so 
much  anxiety  that  he  endeavours  to  escape.  The 
thirst  becomes  more  intense,  the  tongue  drier  and 
parched;  the  face  is  red,  bloated,  the  dry  lips  are 
cracked  ;  the  alvine  evacuations  cease  entirely,  and 
the  urine  looks  brown-red.  Bryonia  ought  to  be  re- 
peated every  two  or  three  hours. 

Mercurius  is  an  important  remedy  when  the  fever 
has  the  character  of  erethism  from  the  commence- 
ment. Mercurius  is  best  adapted,  especially  in  the 
commencement  of  the  disease,  to  puffed  leuco-phleg- 
matic  individuals  with  soft  and  spongy  flesh  and  pre- 
dominant inclination  to  catarrh  and  profuse  s\veats, 
and  affected  with  bodily  and  mental  weakness.  It  is 
certain,  that  Mercury  deserves  a  preference  over 
many  other  remedies  when  catarrhal  and  rheumatic 
fevers  turn  into  typhoid.  Mercurius  is  indicated  by 
the  following  symptoms :  a  long  while  before  the 
typhoid  symptoms  set  in,  the  limbs  go  to  sleep  when 
the  patient  sits  or  lies  down,  with  numbness,  insensi- 
bility, and  tingling  in  the  same ;  the  patient  finds  it 
hard  to  drag  his  limbs  along,  sweats  or  is  affected 
with  palpitation  of  the  heart  upon  the  least  move- 


TYPHUS.  229 

ment ;  nevertheless  the  uneasiness  which  he  expe- 
riences in  his  limbs,  compels  him  to  move  his  limbs 
constantly.  Although  the  patient  does  not  yet  com- 
plain of  any  thing  in  particular,  yet  he  is  so  debili- 
tated and  feels  so  ill  all  over  that  he  is  obliged  to  lie 
down ;  he  is  scarcely  inconvenienced  by  any  thing, 
except  slight  heat,  erethism  of  the  blood  and  trem- 
bling, whieh  occasions  a  constant  starting  and  jactita- 
tion of  the  limbs  during  sleep  ;  frequent  watery  stools, 
with  moist  and  coated  tongue,  bitter,  putrid,  pappy 
taste,  slight  thirst,  sensitiveness  to  pressure  in  the  pit 
of  the  stomach,  in  the  umbilical  and  hepatic  region, 
distention  of  the  abdomen.  The  mental  and  physical 
debility  gradually  increases,  fainting  turns  supervene, 
and  the  patient  is  attacked  with  paroxysms  of  spas- 
modic contraction  of  the  limbs  occasioned  by  the  sud- 
den paroxysms  of  vascular  erethism ;  henceforth  he 
finds  it  impossible  to  leave  his  bed. 

If,  in  the  progress  of  the  disease,  the  following 
symptoms  should  occur,  Mercurius  is  still  indicated : 
general  erethism  of  the  nervous  system  ;  the  delirium 
is  not  altogether  inconsiderable  ;  the  chills  which,  in 
the  commencement  of  the  fever,  were  interrupted  by 
flushes  of  heat,  have  yielded  to  a  constant  burning 
heat  with  excessive  desire  for  iced  water.  The  pa- 
tient complains  of  fulness,  painfulness  in  the  epigas- 
trium ;  symptoms  of  a  general  plethora,  especially  in 
the  portal  system,  make  their  appearance ;  frequent 
bleeding  from  the  nose,  from  which  we  may  infer, 
that  the  blood  begins  to  be  decomposed ;  excessive 
restlessness,  anxiety,  vascular  erethism,  pulsations, 
violent  headache,  as  if  the  head  would  burst,  prevent- 
ing sleep  and  frequently  interrupting  it  by  causing  the 
patient  to  start.  Little  by  little  the  patient  becomes 
more  indifferent,  he  is  desponding,  does  not  care  about 
life  ;  he  is  frequently  unable  to  collect  his  senses,  he 
loses  his  memory,  which  loss  is  probably  a  continu- 
ance of  the  previous  dizziness  and  dulness  of  the 
head.  His  face  becomes  livid,  the  eyes  grow  pale, 
the  nose  blackish,  the  gums  swell  and  bleed  readily  ; 
a  putrid  smell  from  the  mouth  makes  its  appearance, 


230  TYPHUS. 

and  colliquative  secretions  of  various  kinds  occur, 
among  which  the  watery,  copious,  colourless,  serous 
or  white  flocculent  stools  are  the  most  characteristic. 
Under  certain  circumstances  Mercurius  corresponds 
to  all  the  varieties  of  typhus,  from  typhus  erethicus 
to  typhus  putridus. 

We  have  now  mentioned  the  principal  remedies 
which  correspond  to  the  typhus  inflammatorius,  with- 
out, however,  intending  to  convey  the  idea,  that  they 
cannot  be  used  in  the  succeeding  stages  of  typhus. 
This  would  be  contradicted  by  the  symptoms  \vhich 
show,  that  all  the  above  mentioned  remedies  may  be 
serviceable  in  any  stage  of  typhus.  We  shall  now 
indicate  the  remedies  which  correspond  more  espe- 
cially to  the  nervous  phenomena  in  typhus,  whether  it 
exist  as  a  primary  disease,  or  a  disease  which  has 
been  developed  out  of  other  diseases.  First  in  rank,  is 

Rhus  toxicodendron.  Upon  the  setting  in  of  the 
precursory  symptoms,  the  patient  complains  of  chilli- 
ness even  near  the  warm  stove,  with  colic  and  diar- 
rhoea, pains  as  if  bruised  in  various  parts,  as  if  the 
flesh  were  beaten  off  the  bones  ;  the  tongue  is  coated 
white,  the  patient  feels  an  inclination  to  vomit,  result- 
ing in  vomiting  of  mucus,  he  complains  of  vertigo ; 
the  parts  upon  which  he  lies,  go  to  sleep  and  feel 
numb,  he  complains  of  an  exceedingly  troublesome 
stinging,  drawing,  and  rigidity  in  the  nape  of  the  neck 
and  back ;  he  feels  worst  when  resting  and  at  night, 
for  at  such  a  time  he  experiences  a  lameness  and 
stiffness  in  the  limbs,  beside  the  other  symptoms.  As 
the  disease  progresses,  he  feels  extremely  \veak  to  such 
an  extent,  that  he  is  unable  to  remain  out  of  his  bed, 
from  which  an  apprehensive  anxiety  and  a  disagree- 
able feeling  of  heat  constantly  impel  him  to  escape  ; 
his  sleep  becomes  restless ;  he  tosses  about  and  un- 
covers himself  constantly,  the  uncovered  parts  feeling 
so  chilly,  that  it  makes  him  wide  awake,  and  sleep  is 
prevented  by  the  excessive  erethism  of  the  circulation 
and  by  a  variety  of  fancies  ;  if  he  should,  however, 
fall  asleep,  his  sleep  is  disturbed  with  the  most  trou- 
blesome dreams. 


TYPHUS.  231 

As  the  fever  progresses,  a  typhus  abdominalis  be- 
comes more  and  more  marked ;  the  evening  chilli- 
ness, which  is  followed  in  bed  by  several  hours'  dry 
heat  and  thirst,  cutting  as  with  knives  in  the  abdo- 
men, and  diarrhoea,  disappears  entirely  and  is  changed 
to  a  continuous  heat  with  violent  delirium,  pains  in 
the  limbs,  excessive  weakness,  dry,  blackish  tongue 
and  lips,  burning-red  cheeks,  subsultus  tendinum, 
floccilegium,  sopor  with  muttering  and  snoring,  small 
accelerated  pulse.  When  the  delirium  abates,  the 
greatest  anguish  is  depicted  in  the  features,  which 
takes  place  more  frequently  before  than  after  mid- 
night, and  is  accompanied  with  prostration  of  strength. 
If  the  patient  should  be  on  the  point  of  falling  asleep 
again,  he  is  constantly  prevented  from  so  doing  by 
starting  as  in  affright.  The  following  are  some  of 
the  accompanying  symptoms :  Redness  and  lachryma- 
tion  of  the  eyes,  which  are  no  longer  susceptible  of 
any  impression  from  \vithout,  dryness  of  the  nose, 
collapse  of  countenance,  fetid  odour  from  the  mouth, 
involuntary  discharge  of  stool  and  urine  ;  the  urine 
is  whitish  and  turbid  during  emission,  before  any  col- 
liquative  symptoms  had  set  in,  and  becomes  much 
more  so  by  standing  ;  oppression  of  the  chest  is  a 
characteristic  symptom  for  Rhus ;  this  oppression 
continues  from  the  commencement  to  the  end  of  the 
disease,  whether  terminating  in  death  or  recovery. 

Rhus  is  one  of  the  most  distinguished  remedies 
both  in  the  commencement  and  the  progress  of  the 
disease,  in  typhus  versatilis  as  well  as  in  stupidus 
(especially  in  the  latter) ;  it  is  likewise  of  great  value 
during  the  stage  of  convalescence,  when  the  improve- 
ment is  very  slow,  the  pulse  continues  feverish,  there 
is  an  appetite,  but  more  for  particular  things,  than  for 
natural  simple  food  ;  there  is  yet  some  inclination  to 
diarrhoea,  and  the  oppression  of  the  chest  is  not  en- 
tirely removed. 

Xext  to  Rhus  is  Phosphorus,  which  is  principally 
indicated,  \vhen  typhus  arises  from  onanism  or  from  a 
slight  cold.  This  kind  of  typhus  has  a  long  precurso- 


232  TYPHUS. 

ry  stage,  commencing  with  rheumatic  pains  in  the 
upper  and  lower  limbs,  and  accompanied  by  a  capri- 
cious sensitiveness  ;  those  pains  are  generally  very 
intense  early  in  the  morning  and  evening,  in  bed, 
they  increase  when  a  current  of  cool  air  comes  in 
contact  with  the  limb,  and  are  frequently  accompa- 
nied by  other  symptoms,  such  as  :  rheumatic  drawing 
in  the  nape  of  the  neck,  stiffness  of  the  affected 
limbs,  toothache,  weariness,  and  a  bruised  feeling  in 
all  the  limbs,  vascular  erethism  with  dulness  and 
tightness  of  the  head,  palpitation  of  the  heart,  stitches 
in  the  pit  of  the  stomach,  cutting  pain  in  the  bowels, 
and  a  general  sick  feeling.  If  these  symptoms  should 
continue  for  any  length  of  time  without  any  change 
for  the  better  being  effected  by  the  medicine,  the  dis- 
ease reaches  a  higher  degree  characterized  by  the 
following  symptoms : 

The  continuous  heat  is  accompanied  by  a  small, 
hard,  quick  pulse,  throbbing  of  the  carotids,  profuse 
night-sweats ;  the  sleep  is  interrupted  by  shrieks, 
constant  fancies,  moaning,  tossing  about,  \vant  of 
breath,  stitches,  rattling  in  the  chest,  oppressive 
cough  with  bloody  expectoration  (pneumo-typhus)  ; 
upon  waking  the  patient  complains  of  great  heat,  dry 
mouth  with  thirst,  painfulness  of  every  part  of  the 
body.  These  symptoms  are  accompanied  with  sensi- 
tiveness and  rumbling  in  the  coecal  region,  especially 
when  making  pressure  upon  it,  burning  •feeling  in  the 
abdomen  and  anus,  frequently  accompanied  by  half 
liquid,  bloody  stools ;  vertigo  with  stoppage  of  the 
head ;  the  stupefaction  and  beating  pains  in  the  head 
are  very  great,  there  is  a  gauze  before  the  eyes,  hard- 
ness of  hearing,  frequent  discharge  of  blood  from  the 
nose  when  blowing  it,  and  heat  in  the  face.  The 
tongue  and  lips  are  dry  and  parched  ;  the  appetite  is 
entirely  wanting ;  the  patient,  when  conscious,  com- 
plains of  bitter  taste.  (Phosphorus  is  frequently  in- 
dicated when  the  patient  lies  in  a  state  of  stupor.) 
The  urinary  discharges  are  copious,  at  times  deposit- 
ing a  reddish,  at  times  a  white  flocculent  sediment. 


TYPHUS.  233 

A  striking  symptom  is  the  excitation  of  the  sexual 
organs,  which  occurs  in  both  sexes,  and  frequently  in- 
creases to  satyriasis  and  nymphomania. 

Phosphoric  acid  is  closely  related  to  Phosphorus,  but 
more  so  to  Pulsatilla.  Phosphorus  may,  under  certain 
circumstances,  be  employed  against  any  form  of 
typhus  ;  Phosphoric  acid  has  a  more  limited,  but  at  the 
same  time  more  definite  sphere  of  activity.  Even  the 
precursory  symptoms  of  p  phosphoric  acid  typhus  are 
so  well  marked  that^here  can  be  no  doubt  as  to  the 
selection  of  the  rerjae'ay.  The  symptoms  are  frequently 
occasioned  by  long  grief,  chagrin,  care,  and  increase 
to  such  an  extent  that  they  become  dangerous  to  life. 
The  precursory  stage  almost  always  commences  with 
a  gastric  derangement,  which  is  even  characterized  by 
the  peculiar  eruption  about  the  mouth ;  there  is  a 
striking  rising  of  air,  with  nausea,  which  compels  him 
to  lie  down,  and  then  frequently  increases  to  a  consid- 
erable vomiting,  with  extreme  sensitiveness  of  the 
stomach  and  pit  of  the  stomach,  \vhich  increases  more 
and  more  as  the  vomiting  continues,  and  extends  over 
the  whole  abdomen.  The  appetite  is  entirely  wanting, 
the  thirst  is  great,  the  patient  has  a  particular  desire 
for  acid,  juicy  drinks.  Diarrhoea  supervenes  with 
borborygmi  in  the  distended  abdomen ;  the  frequent 
light-yellow  stools  require  more  particularly  the  ex- 
hibition of  Phosphoric  acid.  If  these  symptoms  be 
accompanied  by  intense  pain  in  the  inmost  parts  of 
the  lower  abdomen,  which  is  even  aggravated  by  the 
contact  of  the  shirt ;  if  a  red  miliary  eruption  make 
its  appearance  in  various  parts  ;  if  the  pulse  be  fre- 
quent, \veak,  sometimes  intermittent ;  if  the  patient 
be  unable  to  collect  his  senses ;  if  muttering  delirium, 
stupor,  burning  heat  of  the  skin,  a  dry,  parched  state  of  the 
buccal  cavity,  and  permanency  of  the  recumbent  posture 
be  present,  frequent  doses  of  acidumphosphoricum  will 
effect  the  desired  improvement.  This  remedy  is  always 
most  suitable  in  the  commencement,  as  well  as  in  the 
progress  of  a  typhus  stupidus,  whether  this  arise  from 
a  gastric  or  erethic  typhus  :  characteristic  indications 
for  Phosphoric  acid  are  bland  delirium,  or  silent  and 


234  TYPHUS. 

quiet  recumbent  posture,  the  patient  giving  a  proper 
answer  for  a  few  moments,  but  shortly  afterwards  re- 
lapsing again  into  his  former  condition. 

Having  spoken  of  a  typhus  stupidus,  we  ought  to 
allude  to  a  remedy  which  is  closely  allied  to  Phosphoric 
acid,  and  is  yet  too  much  neglected  in  typhus,  we  mean 
Acidum  muriaticum.  There  are  two  symptoms  which 
indicate  this  remedy  exclusively,  they  are  the  follow- 
ing :  the  patient  constantly  settles  down  in  the  bed 
with  moaning  and  groaning  during  sleep,  and  this 
settling  down  takes  place  again  even  after  the  patient 
has  been  raised,  with  constant  muttering  in  the  waking 
state,  and  inability  to  collect  his  senses  ;  the  second 
characteristic  symptom  is :  the  paralytic  condition  of 
the  tongue,  with  great  dryness  in  the  mouth  and  fauces ; 
even  when  fully  conscious,  the  patient  is  not  able  to 
move  his  tongue  as  he  would  like ;  the  tongue  feels 
heavy  and  too  long,  so  that  he  is  unable  to  raise  it. 
The  accompanying  symptoms,  such  as  burning  heat, 
obliging  the  patient  to  uncover  himself,  accompanied 
with  anxious  uneasiness  in  the  body,  the  tossing  about, 
and  the  frequent  waking  from  sleep  ;  the  loss  of  appe- 
tite, aversion  to  nourishment,  etc.,  are  not  sufficiently 
definite  to  indicate  any  one  remedy  in  particular. 
The  intermission  of  the  pulse  every  third  beat,  and  the 
profuse  quantity  of  watery  urine,  might  perhaps  be 
considered  as  characteristic  indications  for  Muriatic 
acid.  As  a  general  rule,  Acidum  muriaticum  is  a  great 
remedy  in  typhus  stupidus. 

The  principal  specific  in  typhus,  especially  in  a  well 
marked  typhus  abdominalis  and  putridus,  is  Arsenic. 
Diseases  of  the  mucous  membranes,  which  have  de- 
veloped themselves  out  of  gastric,  bilious,  and  mucous 
fevers,  constitute  the  greater  part  of  the  curative 
sphere  of  Arsenic ;  diseases  with  intermittent  type 
likewise  correspond  to  Arsenic  ;  this  is  another  reason 
why  Arsenic  is  a  great  remedy  in  typhus,  with  well- 
marked  exacerbations.  The  homeopathic  physician 
will  think  of  Arsenic  even  in  the  commencement  of 
typhus,  if  unimportant  symptoms,  such  as  a  single 
vomiting,  a  diarrhceic  stool,  a  little  pain,  etc.,  should 


TYPHUS.  235 

be  accompanied  with  great  debility,  obliging  the 
patient  to  lie  down,  and  with  drowsiness,  the  sleep 
being  nevertheless  disturbed  by  restlessness  and  anxiety, 
with  burning  heat.  Soon  after  the  seated,  characteristic, 
burning  pains  in  one  side  of  the  abdomen  make  their 
appearance,  with  sensation  as  if  a  heap  of  incandescent 
coal  were  deposited  in  that  region,  with  coldness  of 
the  limbs,  and  parchment-like,  dry,  hot  skin,  panting 
for  drink,  petechiae,  and  white  miliaria.  The  patient 
complains  of  giddiness,  with  buzzing  in  the  ears,  and 
hardness  of  hearing ;  the  countenance  is  pale,  livid, 
and  distorted  in  a  peculiar  manner  ;  aphthae  form  in 
the  mouth,  with  frequent  inclination  to  vomit,  occa- 
sioning a  faint  feeling  every  time  the  inclination 
occurs ;  meteorism,  with  burning  and  excoriating 
alvine  evacuations,  consisting  of  a  yellow  water,  with 
cadaverous  smell,  and  passing  off  without  the  patient 
being  conscious  of  it. 

Further  observations  will  have  to  show  whether 
small  doses  of  Arsenic  are  as  efficient  in  typhus  as 
larger  (the  second,  third,  sixth  attenuation).  As  for 
ourselves,  we  have  cured  our  patients  with  the  lower 
attenuations,  repeating  the  dose  less  frequently  as  the 
improvement  progressed  more  rapidly.  It  ought  to  be 
noticed  that  many  typhus  patients  do  not  complain  of 
pain  in  the  bowels  until  pressure  is  made  upon  the 
part ;  in  this  case  the  pain  is  very  rarely  burning,  but 
on  the  other  hand  so  much  more  characteristic  as  a 
therapeutic  indication. 

Carbo  vegetabilis  holds  almost  the  same  rank  "with 
Arsenic  in  those  forms  of  typhus  for  which  Arsenic  is 
such  an  admirable  specific.  We  have  found  Carbo 
not  only  indicated  in  the  last  stage,  characterized  by 
decomposition  of  the  fluids,  ulceration  of  the  intestinal 
canal,  decubitus  gangraenosus,  stupor,  with  rattling, 
cold  sweat  over  the  "whole  body,  hippocratic  counte- 
nance, small,  weak  pulse  ;  but  also  in  the  second  stage, 
which  is,  in  fact,  its  principal  sphere  of  activity.  In 
the  third  stage  it  has  been  used  with  great  success  by 
many  practitioners.  The  principal  indications  for  its 
use  are  the  following :  burning  stinging  in  the  inmost 


236  TYPHUS. 

parts  of  the  abdomen,  with  great  anguish  and  trouble- 
some flatulence  coming  on  after  every  meal,  and  ao- 
companied  by  loose  stools,  Avith  tenesmus,  burning, 
light-coloured,  bloody,  and  having  a  putrid  smell. 
The  appetite  is  not  entirely  extinct,  the  patient  has  a 
great  desire  for  salt  food  and  coffee,  complete  aversion 
to  meat ;  the  patient  is  afraid  of  taking  any  nourish- 
ment, on  account  of  the  above-named  symptoms,  to- 
gether with  burning  in  the  stomach,  arising  from  it. 
There  is  nightly  agglutination  of  the  eyelids;  the 
patient  suffers  with  hardness  of  hearing,  tingling  in 
the  ears  ;  (Carbo  is  a  very  important  remedy  for  the 
anguish  which  is  occasioned  by  violent  congestions  of 
the  chest  and  head,  and  accompanied  by  burning  skin ;) 
bleeding  of  the  nose,  with  stoppage  of  that  organ, 
which  is  maintained  by  a  constant  formation  of  scurfs  ; 
eruption  around  the  nose,  and  the  blackish-looking 
chapped  lips  ;  the  patient  sleeps  with  his  limbs  drawn 
up  ;  it  is  a  restless  sleep  and  frequently  interrupted 
by  waking.  On  raising  the  head  the  patient  feels 
giddy,  and  is  extremely  unhappy  and  oppressed. 
Carbo  is  a  most  important  remedy  in  typhus  abdomin- 
alis  during  the  ulcerative  stage. 

When  the  above-mentioned  symptoms  occur,  Rhus, 
Acidum  nitr.,  Phosphorus,  and  Lycopodium  ought 
likewise  to  be  considered.  Rhus  and  Nitric  acid  when 
the  pains  are  not  very  burning ;  Acidum  nitricum  is 
indicated  when  certain  parts  of  the  abdomen  are  very 
sensitive  to  pressure,  with  dragging,  stinging  pain  in 
the  rectum,  evacuations  of  green  mucus,  difficult  urin- 
ation, tendency  to  collapse ;  Lycopodium  deserves 
consideration  when  the  urine  is  burning. 

An  incomparable  remedy  in  the  first  stage  of  the 
disease  is  Staphysagria,  when  the  following  symptoms 
occur :  sordes  on  the  teeth,  pale  and  bleeding  gums, 
with  painful  swelling  of  the  gums,, and  rapid  decay  of 
the  teeth  ;  vanishing  of  thoughts  and  ideas,  weakness 
of  memory,  dulness  of  mind,  great  indifference  and  ill 
humour ;  vertigo,  \vith  stupifying  headache  ;  dimness 
of  the  eyes,  itching,  stinging,  and  heat  in  the  canthi  ; 
fulness  in  the  pit  of  the  stomach,  with  frequent  hickup 


TYPHUS.  237 

and  vomiting ;  tension  across  the  hypochondria,  op- 
pressing the  breathing  ;  pressure,  weight,  and  tension 
in  the  abdomen  ;  cutting  pain  in  the  bowels,  with 
nausea  ;  copious  diarrhoeic  stools.  As  a  general  rule, 
Staphysagria  is  the  best  remedy,  if  the  sexual  organs 
are  involved,  and  if  the  characteristic  pains  in  the 
chest,  heart,  and  spinal  marrow,  the  various  gastric 
troubles,  the  fetid-smelling  sweats,  the  weariness  and 
bruised  feeling  in  the  limbs,  the  morning  and  evening 
febrile  erethism  occur ;  all  those  symptoms  point  to  a 
deep-seated  affection  of  the  nervous  system,  the  com- 
plete development  of  which  is  frequently  prevented  by 
Staphysagria. 

In  the  second  stage  of  the  disease  Valeriana  is 
frequently  an  efficient  remedy,  when  white  miliaria 
and  bland  delirium  have  made  their  appearance. 
The  miliaria  occurs  most  frequently  on  the  chest  and 
in  the  nape  of  the  neck,  it  causes  a  burning  and  stinging 
sensation  and  announces  itself  a  few  days  previous  to 
its  breaking  out  by  stinging  pains  in  the  pit  of  the 
stomach  and  a  continuous  oppression  of  the  chest ; 
this  latter  symptom  is  greatly  relieved  by  dry  cup- 
ping at  the  pit  of  the  stomach.  The  delirium  is  ac- 
companied with  great  nervous  erethism  and  tremor, 
and  consists  of  illusory  notions,  such  as :  the  patient  is 
not  herself,  but  some  one  else,  to  whom  she  has  to 
give  way,  on  which  account  she  keeps  constantly 
pushing  towards  the  edge  of  the  bed ;  or  she  is  in  a 
carriage  and  has  to  make  room  for  some  other  person 
to  come  in ;  or  some  animals  are  lying  by  her  side 
which  she  fears  she  will  crush  by  the  weight  of  her 
body,  and  the  like.*  The  patient  complains,  more- 
over of  great  pains  in  the  limbs,  especially  in  the  feet, 
which  are  spasmodically  stretched,  are  extremely  sen- 
sitive to  contact,  and  resume  their  natural  position 
only  gradually  as  the  patient  improves.  The  pains 
which  the  patient  experiences  in  the  limbs,  likewise 

*  The  reader  will  perceive  that  these  symptoms  are  spoken  of  as  belong- 
ing to  a  female  patient ;  we  may  infer  from  this  that  Hartmann  has  met 
such  a  group  of  symptoms  in  his  practice  in  a  female  patient,  and,  having 
cured  it  with  Valeriana,  has  inserted  it  here  as  a  group  of  general  occur- 
rence.— HEMPEL  . 


238  TYPHUS. 

involve  the  spinal  column,  decubitus  supervenes  very 
speedily.  As  a  general  rule  Valeriana  may  be  em- 
ployed in  typhoid  fevers  which  commence  with  an 
irritation  of  the  spine,  as  manifested  by  violent 
spasms,  asthma,  distortions  of  the  countenance,  &c. 
The  appetite  never  disappears  entirely,  but  the  thirst 
is  much  greater ;  the  febrile  heat  is  continuous,  the 
pulse  being  accelerated  and  weak,  100  beats  a 
minute  ;  the  sleep  is  restless,  disturbed  with  anxious 
dreams,  during  which  the  patient  constantly  endea- 
vours to  uncover  himself.  The  abdomen  is  sensitive 
to  the  touch  in  the  ileo-coecal  region,  it  is  generally 
distended  ;  costiveness,  scanty,  turbid  urine. 

§  75.  In  typhus  gastricus  the  following  remedies 
are  the  most  efficient :  Ipec.,  Cham.,  Puls.,  Ignat., 
Nux,  Cocculus,  Arnica,  China,  Digitalis.  Ipec.  is  in- 
dicated when  the  gastric  symptoms  prevail ;  by  slimy, 
bilious  diarrhceic  stools,  occasioned  by  the  abuse  of 
pork  and  pastry  (see  also  Pulsatilla)  and  appear  in 
company  with  spasmodic  pains.  Children  and  fe- 
males being  particularly  predisposed  for  such  affec- 
tions, Ipec.  is  especially  useful  to  those  classes  of 
persons,  and  the  more  so  when  the  following  symp- 
toms occur :  the  spasms  consist  in  tossing  the  head 
to  and  fro,  distorting  the  features,  jactitating  the 
limbs,  stretching  the  body  as  if  in  a  state  of  rigor 
(spinal  irritation) ;  starting  from  sleep  as  in  affright, 
violent,  general  heat,  especially  in  the  evening  hours, 
accompanied  with  great  nervousness  and  irritable 
mood ;  yellow  coating  of  the  tongue  with  constant 
inclination  to  vomit,  and  vomiting  of  bilious  sub- 
stances, &c.  (see  gastric  and  bilious  fevers). 

On  a  par  with  Ipec.  ranks  Chamomilla,  when  con- 
vulsions and  spasmodic  symptoms  occur,  with  bright- 
red,  dry,  cracked  tongue,  lined  with  a  yellowish-white 
coating,  slimy,  putrid,  and  bitter  taste,  putrid  smell 
from  the  mouth ;  inclination  to  vomit,  and  bitter 
vomiting  of  food  ;  pressure  at  the  stomach  and  dis- 
tention  of  the  abdomen  with  great  sensitiveness  to  pres- 
sure, with  cutting,  burning,  and  pinching  pains;  diar- 
rhoea stools  of  white  or  yellowish-green  mucus  ;  urine 


TYPHUS.  239 

with  yellow  flocks ;  catarrhal  symptoms ;  great  ner- 
vous erethism  ;  vivid  fancies  both  during  sleep,  which 
is  full  of  dreams,  and  in  the  waking  state  during  the 
febrile  heat  which  is  accompanied  with  great  thirst. 

We  refer  the  reader  to  the  chapter  on  the  gastric 
fevers  for  a  more  detailed  account  of  the  symptoms 
indicating  the  preceding  as  well  as  the  succeeding 
remedies. 

Pulsatilla  is  a  great  remedy  in  typhus  gastricus. 
This  remedy  is  adapted  to  persons  with  a  mild,  yield- 
ing temperament  and  a  timid  disposition  with  incli- 
nation to  weep.  The  febrile  heat  is  always  mingled 
with  chilliness  which  comes  on  as  soon  as  the  patient 
uncovers  himself;  there  is  no  thirst ;  the  pulse  is 
quick  and  small ;  bland  delirium,  weeping,  wringing 
one's  hands,  alternating  with  sopor. 

Ignatia  is  adapted  to  persons  with  fitful  temper, 
changing  from  mirth  to  sadness.  The  fever  is  almost 
always  accompanied  with  sudden  flushes  of  heat, 
headache,  pain  in  the  pit  of  the  stomach,  great  debili- 
ty, occasional  alternation  of  redness  and  paleness  of 
the  countenance,  dry,  chapped  lips,  white  tongue, 
deep  sleep  with  snoring,  accelerated  small  pulse,  and 
the  gastric  and  bilious  symptoms  which  characterize 
this  remedy. 

Nux  is  equal  to  any  of  the  above-named  remedies 
in  this  variety  of  typhus ;  in  many  respects  it  is  supe- 
rior, since  the  action  of  Nux  extends  over  almost  all 
the  organs  and  systems  of  the  human  organism. 
Pulsatilla  is  closely  related  to  Nux,  but  more  so  to 
Phosphoric  acid.  The  difference  between  Nux  and 
Pulsatilla  is  more  general  than  special.  Puls.  is  more 
suitable  to  females,  Nux  more  to  males ;  Puls.  cor- 
responds to  the  mild  yielding  temper,  Nux  to  a  lively, 
sanguine,  choleric  temperament  and  an  artful,  mali- 
cious disposition  ;  Pulsat.  is  indicated  by  predominant 
paleness,  Nux  by  a  bright-red  complexion,  and  in 
general  by  plethora  which,  in  many  persons,  is  indi- 
cated by  haemorrhoids.  These  are  the  general  dif- 
ferences. The  particular  indications  for  Nux  are  the 
following :  troublesome  heat  which  is  frequently 


240  TYPHUS. 

mingled  with  flushes  ;  hard,  full  and  frequent  pulse  ; 
pains  and  debility  in  the  limbs,  tightness  and  dulness 
of  the  head,  vertigo,  aching  pain  in  the  forehead 
(relieved  by  laying  the  head  upon  the  table)  ;  oppres- 
sive crampy  pains  in  the  stomach  and  a  tensive  pres- 
sure in  the  pit  of  the  stomach  with  nausea,  bitter 
taste  and  eructations,  with  yellowish  coating  of  the 
tongue,  complete  loss  of  appetite  and  vomiting  of  the 
ingesta,  cutting  spasms  in  the  abdomen,  constipation, 
painful  emission  of  urine,  which  looks  reddish  and 
frequently  bloody  ;  all  impressions  from  without  are 
intolerable  to  the  patient,  he  is  deeply  affected  by 
them,  he  moans,  groans,  he  becomes  vehement,  even 
unto  rage. 

Cocculus  ranks  on  a  par  with  Nux,  when  the  gas- 
tric symptoms,  such  as :  loss  of  appetite,  aversion  to 
any  kind  of  food  or  drink,  inclination  to  vomit  and 
nausea  unto  fainting,  bitter  eructations,  painful  op- 
pression in  the  pit  of  the  stomach,  and  constrictive 
spasms  in  the  abdomen  in  the  direction  of  the  in- 
guinal ring,  frequent,  small,  diarrhceic  feculent  evac- 
uations, are  accompanied  by  heat  of  the  upper  part 
of  the  body,  chills  of  the  lower  limbs,  cold  feet, 
burning  heat  in  the  whole  countenance,  burning 
thirst,  sudden  attacks  of  violent  anguish,  &c.  This 
remedy  deserves  consideration  whenever  typhus  de- 
velopes  itself  out  of  a  severe  illness,  or  is  brought  on 
by  frequent  chagrin.  In  this  case  it  is  indicated  by 
frequent  attacks  of  a  disagreeable  burning  heat  and 
redness  of  the  cheeks,  by  evening  exacerbations  char- 
acterized by  hot  hands  and  a  sensation  of  dry  heat 
over  the  whole  body,  with  nightly  sleeplessness  and 
delirium ;  by  frequent  shiverings  in  the  day-time, 
with  great  debility,  obliging  one  to  lie  down ;  great 
sensitiveness  of  feeling,  extreme  ill  humour,  depres- 
sion of  the  vital  energy,  tremor  of  the  limbs,  paraly- 
tic immobility  of  the  limbs,  hemiplegia,  sudden  attack 
of  anguish  with  shortness  of  breath  and  palpitation 
of  the  heart. 

Arnica  is  a  valuable  remedy  not  only  in  typhus 
gastricus,  but  also  in  genuine  typhus,  if  stinging  pains 


TYPHUS.  241 

with  pressure  be  felt  in  the  head,  especially  the  fore- 
head, with  frequent  bleeding  at  the  nose  which  does 
not  afford  any  relief,  with  continuous  general  heat, 
external  and  internal  chilliness,  and  unquenchable 
thirst  during  night.  Arnica  is  likewise  an  excellent 
remedy  in  typhus  stupidus,  when  the  patient  is  entire- 
ly unconscious  of  himself,  like  one,  whose  brain  has 
been  violently  concussed ;  the  patient  does  not  stir, 
nor  is  any  delirium  present. 

China  may  prove  useful  for  the  following  symp- 
toms :  tearing  pains  in  the  head  with  pressure,  espe- 
cially at  night,  accompanied  with  anguish,  fear,  un- 
easiness with  subsequent  sleeplessness,  congestion  of 
blood  to  the  head  with  heat,  fulness,  vertigo,  buzzing 
in  the  ears,  hardness  of  hearing,  pale,  sunken  coun- 
tenance ;  dryness  of  the  mouth,  yellow  coating  of  the 
tongue,  slimy  bitter  taste,  great  desire  for  cold  water ; 
heartburn  after  eating  but  little,  empty  retching,  car- 
dialgia,  constrictive  flatulent  colic  deep  in  the  abdo- 
men, and  pressing  of  the  flatulence  from  within  out- 
ward, with  tension  and  anxiety  below  the  hypochon- 
dria, and  diarrhoeic,  slimy  stools  containing  undigested 
food  ;  white  and  turbid  urine ;  oppression  of  breath- 
ing, especially  in  the  evening,  with  uneasiness  in  the 
chest  and  a  small,  feeble  pulse  ;  general  chilliness 
and  rather  cool  extremities.  All  these  symptoms, 
which  are  characteristic  indications  for  China,  point 
to  a  rather  acute  as  well  as  slow  typhus  gastricus, 
and  likewise  to  a  difficult  convalescence,  arising  from 
a  depression  of  the  vital  forces  by  exhausting  evacua- 
tions and  secretions. 

Digitalis  likewise  corresponds  to  a  typhus  gastricus. 
Even  before  the  physician  has  thought  of  the  disease, 
Digitalis  is  indicated  by  a  constant  desire  to  urinate, 
with  scanty  emission  of  a  dark-brown  urine,  especially 
at  night ;  the  patient  complains  of  dizziness  and 
vertigo  when  rising.  This  condition  of  things,  which 
is  not  very  alarming  of  itself,  frequently  precedes  the 
outbreak  of  the  real  typhus  for  days  and  weeks.  The 
disease  generally  sets  in  with  a  painful  stiffness  in  the 
11 


242  TYPHUS. 

back  and  limbs  which  is  most  intense  after  dinner. 
Weight  and  indolence  in  the  limbs  easily  supervene, 
requiring  the  patient  to  lie  down.  The  first  symptoms 
generally  denote  a  depression  of  the  vital  energies, 
with  slow,  sluggish  pulse.  Characteristic  and  infal- 
lible indications  for  Digitalis,  are :  a  yellowish  com- 
plexion, constant  desire  to  urinate,  disturbing  sleep,  al- 
ternate chills  and  heat,  burning  of  the  head,  face  and 
ears,  redness  of  the  cheeks,  anguish,  excessive  dread  of 
the  future  ;  optical  illusions ;  violent  vomiting  of  bile, 
with  crampy  pains  in  the  stomach  sometimes  relieved 
by  eructations  ;  painful  pressure  in  the  region  of  the 
liver,  etc. 

§  78.  The  remedies  which  we  shall  mention  in  the  fol- 
lowing paragraphs,  are  no  less  efficient  in  the  treatment 
of  typhus  than  any  of  .the  preceding,  and  may  have  to 
be  used  in  any  variety  and  stage  of  typhus  as  the 
symptoms  may  require.  In  order  to  avoid  the  necessity 
of  constantly  recurring  to  the  same  remedy  in  des- 
cribing the  various  groups  of  symptoms  for  which  it 
may  be  required  in  the  various  stages  and  forms  of 
typhus,  we  will  mention  at  once  the  whole  series  of 
the  symptoms  to  \vhich  the  remedy  corresponds  in 
typhus  generally. 

Stramonium  is  particularly  indicated  by  muscular 
spasms,  spasms  of  the  facial  muscles,  pharynx,  especial- 
ly when  drinking  or  generally  when  swallowing,  dis- 
tortion of  the  eyes,  tremor  of  the  limbs,  even  of  the 
tongue  when  protruding  it.  It  will  be  found  efficient 
in  that  form  of  typhus  which  is  occasioned  by  spinal 
irritation ;  the  fever  increases  to  a  great  degree  of 
violence  with  exacerbations  at  different  periods  of  the 
day,  especially  in  the  afternoon  and  at  midnight,  ac- 
companied with  loss  of  consciousness,  trembling,  small, 
rapid,  and  frequently  intermitting  pulse.  The  delirium, 
if  present,  is  generally  of  a  bland  character,  a  sort  of 
unintelligible  muttering ;  the  patient  is  either  in  a 
state  of  sopor  or  sleeplessness  ;  stool  and  urine  are 
frequently  retained.  These  symptoms  denote  evidently 
a  typhus  stupidus  for  which  Stramonium  has  been 


TYPHUS.  243 

employed,  with  success.  It  may  likewise  prove  use- 
ful in  typhus  erethicus.  Closely  related  to  Stra- 
monium and  useful  in  typhus  stupidus,  is 

Hyosciamus.  This  remedy  deserves  attention  when 
the  fever  has  set  in  suddenly  without  any  precursory 
symptoms,  or  perhaps  with  a  sudden  swoon  (see 
Veratrum).  In  spite  of  the  burning  febrile  heat  of  the 
whole  body  with  evening  exacerbations,  without 
thirst,  putrid  taste  in  the  mouth,  red,  dry  tongue  :  the 
pulse  is  small,  slow  and  weak.  The  patient  tosses 
from  side  to  side  owing  to  the  violent  erethism  of  the 
nervous  system,  he  has  no  sleep  ;  if  any  sleep  should 
take  place,  it  is  frequently  disturbed  with  startings  as 
if  by  fright,  grinding  of  the  teeth,  profuse  sweats, 
which  disappear  again  as  soon  as  the  patient  wakes 
and  cannot,  therefore,  be  considered  critical ;  the  skin 
is  dry,  parchment-like,  the  extremities  are  cold,  the 
whole  body  feels  weak  and  exhausted,  there  is  great 
anguish  as  precedes  the  eruption  of  miliaria ;  the 
patient  is  entirely  stupid  and  unconscious,  or  else 
there  is  muttering  delirium,  absurd  talk  and  flocci- 
legium.  Hyosciamus  is  likewise  suitable  for  the  fol- 
lowing symptoms:  excessive  wakefulness,  subsultus 
tendinum,  slight  convulsive  movements  of  the  limbs  ; 
quick,  full,  and  hard  pulse,  with  distention  of  the  veins 
all  over  the  body,  and  burning  heat ;  constant  delirium 
\vith  open  eyes ;  desire  to  escape,  without  knowing 
why  ;  rattling  breathing,  distortion  of  the  features  and 
eyes  ;  demeanour  as  of  a  maniac  ;  scanty  emission  of 
urine,  which  needs  not  to  depend  upon  a  spasm  of  the 
bladder,  but  may  be  occasioned  by  a  diminished  secre- 
tion ;  the  involuntary  emission  of  stools  and  urine 
during  an  absence  of  consciousness  is  no  counter-indi- 
cation of  Hypsciamus,  inasmuch  as  that  phenomenon 
may  occur  in  consequence  of  a  paralytic  weakness  of 
the  sphincter  muscles,  and  of  an  entire  absence  of 
mind  in  the  patient  with  consequent  absence  of  all 
volition.  These  two  symptoms  hold  a  prominent  rank 
among  the  physiological  effects  of  Hyosciamus  upon  the 
healthy  organism. 

Opium  is  another  valuable  remedy  in  typhus.     It  is 


244  TYPHUS.  • 

particularly  indicated  by  the  following  symptoms :  loss 
of  consciousness  and  sopor ;  the  patient  lies  with  open 
eyes,  and  is  speechless ;  the  limbs  are  rigid  ;  the  pulse 
is  quick,  full,  and  hard ;  the  face  is  dark  red,  and 
puffed ;  the  respiration  laboured,  snoring  and  rattling  ; 
all  these  symptoms  afford  an  image  of  a  true  typhus 
stupidus  (apoplecticus),  Opium  will  be  found  efficient 
in  that  condition  of  the  patient.  If  this  condition  have 
lasted  too  long,  and  a  slow,  feeble,  intermittent  pulse 
set  in,  and  those  parts  which  were  bloated  collapse, 
Opium  will  not  do  any  good.  Nor  will  any  other 
remedy.  Death  will  soon  take  place.  If  the  patient 
should  be  lying  with  his  eyes  closed,  without  sleeping  ; 
if  the  hearing  and  taste  of  the  patient  should  not  have 
entirely  disappeared  ;  if  the  patient  should  still  give  a 
sign  of  life  when  spoken  to ;  if  there  should  only  be 
the  highest  degree  of  sopor,  without  a  complete  par- 
alysis of  all  the  functions  and  organs  :  in  such  a  case 
it  might  perhaps  be  possible  to  reanimate  the  vital 
energies  and  the  mental  powers.  This  result  could 
only  be  accomplished  by  one  remedy,  which  acts  by 
exciting  the  olfactory  nerves,  it  is  Spiritus  nitri  dulcis, 
which  should  be  applied  to  the  patient's  nose  every 
minute  at  first,  and  afterwards  less  frequently,  as  the 
signs  of  a  restored  vitality  increase.  As  soon  as  the 
patient's  consciousness  has  returned,  the  Spiritus  nitri. 
dulcis  ceases  to  do  good,  and  Rhus,  Nux,  Belladonna, 
Pulsat.,  Acid,  phosphoricum,  or  some  other  remedy  will 
have  to  be  employed. 

Camphor  has  been  employed  with  great  success  in 
typhus  by  many  homoeopathic  physicians.  By  some 
Camphor  has  been  found  useful  after  Rhus,  especially 
when  the  following  symptoms  occurred  :  violent  de- 
lirium, hot  and  tight  and  dull  head ;  cold,  clammy 
skin,  with  colliquative  sweats  ;  great  debility,  inclina- 
tion to  diarrhoea.  More  particular  indications  for 
Camphor  are  the  following :  the  febrile  paroxysm  sets 
in  with  a  sudden  loss  of  sense,  falling  down  without 
consciousness,  spasmodic  stretching  of  the  body, 
twitchings  of  the  facial  muscles,  and  shortness  of 
breath.  After  these  symptoms  have  disappeared,  the 


TYPHUS.  245 

patient  complains  of  a  constrictive,  beating  headache, 
with  burning  hot  forehead,  cold  hands  and  feet ;  the 
headache  increases  by  every  change  of  position ;  verti- 
go sets  in,  as  if  the  patient  would  fall  over,  with  loss  of 
consciousness,  weak  and  scarcely  perceptible  pulse ; 
these  symptoms  are  gradually  followed  by  heat,  which 
is  first  felt  in  the  face,  and  then  over  the  whole  body, 
hands  and  feet  remaining  cold ;  loss  of  thirst ;  scanty 
and  rare  emission  of  turbid  urine,  depositing  a  thick 
sediment. 

Cina  is  said  to  be  very  useful  in  typhus,  since  it  has 
a  powerful  stimulating  action  upon  the  nerves  of  the 
abdomen.  Cina  corresponds  most  accurately  to  a 
worm  fever,  with  typhoid  symptoms ;  when  such  symp- 
toms occur,  Cina  is  probably  of  importance  only  in  the 
commencement,  when  burning  heat  of  the  face,  red- 
ness of  the  cheeks,  increased  desire  for  cold  drinks, 
slight  delirium,  restlessness,  tossing  about,  prevail, 
especially  in  the  evening  and  at  night ;  between  the 
exacerbations  the  patient  shows  a  sort  of  indifference 
to  either  agreeable  or  disagreeable  things,  although  he 
calls  for  a  good  deal ;  he  complains  of  a  numb  and 
stupifying  pain  in  the  head,  with  sensation  as  if  the 
head  were  screwed  in ;  this  pain  increases  to  such  a 
degree  that  it  causes  convulsions  and  contortion  of  the 
limbs. 

Hellebore  has  been  recommended  in  typhus,  which 
has  developed  itself  out  of  some  other  disease  ;  for 
instance :  out  of  scarlatina,  measles,  cholera,  gastric 
and  worm  fever,  etc.  Hellebore  corresponds  more  or 
less  to  the  following  symptoms  :  internal  chills  in  the 
evening,  in  bed,  with  burning  heat  over  the  whole 
body,  especially  the  head,  with  glowing  cheeks,  ab- 
sence of  thirst,  sometimes  even  aversion  to  drink. 
Particular  indications  for  Hellebore  are  :  the  febrile 
symptoms  wrhich  have  been  mentioned  in  the  preceding 
paragraph,  and  which  are  accompanied  by  the  follow- 
ing symptoms :  bloatedness  of  different  parts  of  the 
body,  with  heaviness  in  the  same  ;  sopor,  with  numer- 
ous fancies,  and  tossing  to  and  fro ;  hypochondriac 
mood,  and  dulness  of  sense  ;  the  scalp  feels  bruised, 
with  GBdema  of  the  whole  body ;  dark,  turbid  urine. 


246  TYPHUS. 

Among  the  symptoms  of  Lachesis  we  distinguish  the 
following  typhoid  condition :  chilliness  every  evening, 
with  drawing  in  the  back,  and  in  the  lower  limbs  from 
below  upwards ;  dry  heat  at  night ;  loss  of  appetite 
and  exhaustion.  In  a  few  days  the  following  symp- 
toms supervene  :  vertigo  when  sitting  up  in  the  bed  ; 
the  eyelids  feel  paralyzed,  and  it  is  difficult  to  open 
them  ;  bitterness  in  the  mouth ;  simple  pain  in  the 
chest  and  dry  cough,  tearing  in  the  left  thigh  and  back. 
After  these  symptoms  have  lasted  some  time,  a  sopor- 
ous  condition  sets  in  after  the  patient  has  passed  a  very 
restless  night,  characterized  by  a  sort  of  stupified  lying 
on  the  back,  from  which  the  patient  only  wakes  by 
shaking  him  violently,  and  talking  to  him  with  a  loud 
voice  ;  his  tongue  is  very  heavy  when  talking  ;  sunken 
countenance,  the  lower  jaw  is  hanging  down ;  the 
pulse  is  seventy,  soft,  unequal ;  some  sweat,  with  cool- 
ness of  the  legs  and  feet ;  the  tongue  is  red,  smooth, 
dry,  and  he  protrudes  it  with  great  difficulty.  He  emits 
a  copious  quantity  of  brown-red  urine. 

Secale  has  been  found  efficient  by  several  homoeo- 
paths in  typhus  arising  from  other  diseases,  as  well  as 
in  that  arising  from  an  irritation  of  the  spinal  mar- 
row. The  patients  gradually  lose  their  appetite,  de- 
sire to  drink  continually,  especially  cold  water,  are  in 
a  constant  state  of  fever,  which  consists  principally  of 
dry  heat,  with  hurried  pulse  ;  they  are  very  restless, 
sleepless,  debilitated ;  they  complain  of  wandering 
pains  in  the  back  and  small  of  the  back,  gradually 
assuming  a  spasmodic  character,  and  flying  from  one 
part  to  another ;  those  spasms  are  of  a  tonic  character 
in  the  feet  and  hands,  clonic  in  the  facial  muscles, 
with  subsultus,  tremulousness,  jerks;  the  spasms  in  the 
muscles  of  the  chest  occasion  asthma.  Secale  is  a 
distinguished  remedy  in  that  stage  of  the  fever ;  if  re- 
peated every  two  or  three  hours  the  spasmodic  pains 
soon  disappear,  after  which  another  remedy  may  be 
exhibited,  unless  the  delirium  and  the  fever  should 
have  subsided  under  the  influence  of  Secale. 

Lycopodium,  of  which  mention  has  been  made 
above,  is  not  only  applicable  to  a  few  single  symptoms 
in  typhus,  but  to  typhus  generally.  It  has  been  sue- 


TYPHUS.  247 

cessfully  employed  in  those  fevers  when  they  were 
characterized  by  constipation,  waking  with  ill  humour, 
scolding,  screaming,  and  various  improper  manners. 
Characteristic  indications  for  Lycopodium  are :  nervous 
erethism,  without  heat  of  the  head  or  redness  of  the 
face,  circumscribed  redness  of  the  cheeks,  great  de- 
bility, sweats  which  do  not  relieve,  and  a  red,  dry 
tongue. 

In  order  to  enable  the  beginning  practitioner  of 
homoeopathy  to  select  Lycopodium  with  a  tolerable 
degree  of  certainty,  we  shall  try  to  define  the  group  of 
symptoms  for  which  Lycopodium  is  more  particularly 
adapted.  The  Lycopodium  typhus  commences  with 
a  concealed  chilliness  which  continues  for  several  days, 
is  worse  towards  evening,  the  skin  being  cold  to  the 
touch  all  over,  and  the  sleep  not  being  particularly 
disturbed  by  the  coldness ;  in  a  few  days  the  chilliness 
gives  way  to  a  burning  heat  all  over  the  body,  accom- 
panied with  shortness  of  breathing,  slight  thirst,  ful- 
ness of  countenance,  frequent  startings  from  sleep,  and 
vertigo  when  rising,  as  if  everything  turned  in  a  circle. 
Gradually  the  sleep  becomes  more  and  more  restless, 
disturbed  with  fancies  and  a  number  of  confused 
dreams,  occasioning  a  constant  tossing  about,  shriek- 
ing, and  waking  ;  the  patient,  even  when  of  a  mild 
temper,  becomes  irritable  and  sensitive,  vehement ; 
tightness  and  dulness  of  the  head,  difficulty  to  think, 
selection  of  wrong  words  when  talking,  and  a  slight 
delirium  supervene.  The  skin  remains  dry,  even  when 
the  fever  increases ;  the  tongue  becomes  dry,  heavy, 
is  painful  as  if  burnt,  without  thirst,  or  but  little  desire 
for  water ;  the  patient  is  extremely  faint  and  debili- 
tated ;  frequent  ineffectual  urgings  for  stool  make  their 
appearance,  accompanied  with  frequent  but  scanty 
discharges  of  burning,  dark  brown  urine,  especially  at 
night.  These  fevers  are  always  accompanied  with 
shortness  of  breath,  congestion  of  blood  to  the  chest, 
palpitation  of  the  heart. 

Natrum  muriaticurn  has  likewise  been  recommended 
in  typhus  characterized  by  weakness,  dryness  of  the 
tongue,  and  great  thirst.  Characteristic  indications 


248  TYPHUS. 

for  Natrum  mur.  are  :  typhus  following  upon  exhaust- 
ing diseases  ;  typhoid  symptoms  may  be  prognosticated 
when  the  patient  is  unable  to  recover  his  strength, 
complains  of  bruised  feelings  in  the  limbs,  depriving 
him  of  his  night's  rest  by  arresting  ,as  it  were  the 
breathing  ;  extreme  mental  and  physical  debility,  con- 
tinuous febrile  heat,  with  evening  exacerbation  ;  quick, 
full  pulse ;  hurried,  oppressed  breathing ;  constant 
palpitation  of  the  heart,  with  anguish,  headache,  as  if 
the  head  would  burst,  especially  in  the  forehead,  with 
such  a  violent  throbbing  in  the  forehead  that  the 
patient  sometimes  loses  his  senses  and  becomes  de- 
lirious ;  the  complexion  is  livid,  the  tongue  dry  and 
heavy,  so  that  he  is  scarcely  able  to  talk ;  aversion  to 
food  ;  a  good  deal  of  thirst — which,  when  quenched, 
occasions  a  distention  of  the  abdomen,  and  a  good  deal 
of  rumbling  and  cutting  in  the  bowels,  sometimes  even 
an  inclination  to  vomit,  and  small  watery  stools  ;  there 
is  a  copious  secretion  of  urine,  which  deposits  a  brick- 
dust  sediment. 

§  77.  Some  physicians  have  recommended  Sulphur 
in  the  treatment  of  typhus.  In  our  opinion  Sulphur 
ought  only  to  be  given  for  the  purpose  of  restoring  the 
susceptibility  of  the  organism  to  the  action  of  one  or 
the  other  of  the  remedies  which  we  have  indicated  for 
typhus.  In  this  respect  Sulphur  acts  like  Opium  and 
Mercury,  and  should  be  employed  when  the  following 
indications  for  its  use  are  present :  the  typhus  is  a 
consequence  of  some  acute  cutaneous  disease  ;  or  the 
patient  has  been  affected  in  former  times  with  some 
chronic  cutaneous  affection  ;  it  is  likewise  useful 
when  Pulsat.,  Merc.,  and  Nux,  although  they  seemed 
to  correspond  to  the  symptoms,  had  no  effect,  or  when 
the  action  of  the  specific  remedies  is  prevented  by  the 
abuse  of  spirits  to  which  the  patient  was  addicted  pre- 
vious to  his  illness.  Sulphur  is  likewise  indicated 
when  the  patient  is  of  a  scrofulous  habit  and  had  been 
complaining  of  pains  in  the  limbs  previous  to  the  in- 
vasion of  typhus  ;  it  may  also  be  usefully  employed 
•when  a  violently  burning  miliary  eruption  frequently 
makes  its  appearance  in  one  or  the  other  part  of  the 


TYPHUS.  249 

body  during  the  course  of  the  disease  ;  or,  finally,  in 
gastric  fevers  with  typhoid  symptoms.  More  particu- 
lar indications  are  the  following :  continuous  profuse 
sweats  which  afford  no  relief ;  the  sleep  at  night  is 
disturbed  with  fanciful  ravings ;  even  when  the  patient 
wakes  the  fancies  continue  to  crowd  upon  the  patient, 
the  head  feels  dizzy  and  benumbed,  which  the  patient 
is  unable  to  account  for ;  he  is  extremely  timid,  inclines 
to  start,  is  out  of  humour,  an/l  easily  vexed  ;  hardness 
of  hearing  ;  sunken  eyes  surrounded  \vith  blue  mar- 
gins ;  pale  and  wretched  complexion ;  dry  and  chap- 
ped lips  ;  dry,  parched,  bright-red  tongue  ;  and  taste 
as  of  blood  in  the  mouth ;  Sulphur  is,  moreover, 
characteristically  indicated  by  the  painfulness  of  the 
abdomen  to  the  touch,  with  sensation  as  if  it  were 
sore  and  raw  inside  ;  there  is  no  diarrhoea,  but  some- 
times such  a  violent  urging  that  the  stools  frequently 
pass  off  involuntarily  ;  this  same  statement  applies  to 
the  urine  which  is  very  rarely  of  the  same  colour,  and 
generally  changes  in  colour  from  time  to  time. 

Spigelia,  Digitalis,  and  the  Muriate  of  magnesia, 
afford  in  many  cases  essential  benefit  in  treating  the 
ailments  \vhich  often  remain  after  typhus.  We  have 
already  spoken  of  Digitalis.  Magnesia  muriatica 
removes  the  pains  as  if  bruised  all  over,  the  great 
debility  and  weight  of  the  limbs,  the  ill  humour  conse- 
quent upon  that  condition  of  the  limbs,  especially  when 
occurring  in  individuals  whose  nerves  are  weak  even 
in  a  state  of  health  ;  the  restless  sleep  at  night  \vhich 
is  frequently  disturbed  by  anxious  dreams,  nightmare ; 
the  sensation  of  oppressive  weight  in  the  head,  which 
frequently  lasts  a  long  while,  and  is  accompanied  with 
vertigo  and  a  dull  and  dreary  feeling. 

Spigelia  corresponds  more  particularly  to  the  feeling 
of  weakness  in  the  reproductive  organs,  without,  how- 
ever, being  an  exclusive  remedy  for  that  condition. 
Characteristic  indications  for  Spigelia  are :  great  de- 
bility after  the  slightest  exercise  ;  sad  and  desponding 
mood,  accompanied  with  a  pressing  pain  in  the  fore- 
head from  within  outwards,  which  extends  deep  into 
orbits  especially  when  stooping  forwards,  and  appears 
11* 


250  TYPHUS. 

\vith  increased  violence  every  other  day ;  the  acid  taste 
in  the  mouth  with  painful  fissures  in  the  tongue  ;  the 
complete  aversion  to  smoking ;  excessive  appetite  and 
great  thirst ;  the  painful  pressure  in  the  pit  of  the  sto- 
mach, which  makes  every  least  pressure  from  without 
unpleasant,  and  is  accompanied  with  palpitation  of  the 
heart  and  anxious  oppression  of  the  chest ;  the  feeling 
of  fulness  in  the  abdomen  even  after  a  moderate  meal, 
with  rumbling  in  the  bow.els  and  papescent  stools. 

§  78.  We  shall  conclude  the  chapter  on  typhus  and 
typhoid  diseases  by  a  few  cursory  remarks  on  certain 
forms  of  typhus,  which  we  have  not  yet  had  an  op- 
portunity to  treat  in  our  country  (Germany),  and  the 
probable  remedies  of  which  we  will  point  out  with  a 
few  broad  indications. 

Before  proceeding  we  will  state,  that  it  is  exceed- 
ingly bad  practice  to  change  the  remedies  every  six 
or  twelve  hours,  as  some  physicians  do,  who  get 
frightened,  if  they  do  not  see  an  improvement  in  that 
time.  Typhus,  if  it  should  have  fully  set  in,  cannot 
be  cut  short  by  a  remedy,  and  all  that  the  physician 
can  do,  is,  to  cure  the  patient.  It  is  therefore  advisa- 
ble to  repeat  the  remedy,  provided  it  has  been  chosen 
with  all  possible  care,  until  an  improvement  takes 
place  in  the  symptoms ;  if  the  patient  should  get  worse, 
this  would  be  positive  evidence  that  the  remedy  was 
not  homo3opathic  to  the  disease.  If  the  symptoms  do 
not  get  worse,  this  may  be  considered  an  improve- 
ment in  typhus ;  it  would  be  indiscreet  to  give  another 
remedy  under  such  circumstances  with  a  view  of  has- 
tening the  cure  ;  wre  might  perhaps  destroy  the  good 
effects  which  we  had  so  far  obtained  by  our  treatment. 
A  frequent  change  of  remedies  is  only  justifiable  in 
case  the  symptoms  should  vary  frequently,  provided 
always  that  the  changes  in  the  symptoms  are  no  me- 
dicinal aggravation.  The  physician  who  conducts  the 
treatment  has  to  decide  about  that.  If  he  should  not 
clearly  recollect  the  physiological  effects  of  the  remedy, 
let  him  either  refresh  his  memory,  or  else  wait  three  or 
four  hours  before  prescribing  a  new  remedy.  At  the 
end  of  that  period  the  disease  will  have  taken  such  a 


TYPHUS. 


251 


turn  as  will  either  justify  or  condemn  the  selection  of 
the  last  remedy.  Should  the  frequent  changes  in  the 
symptoms  constitute  regular  paroxysms,  the  physician 
would  then  have  to  select  among  the  following  reme- 
dies, the  principal  of  which  we  shall  name  first :  Ars., 
Carbo  veg.,  Veratrum,  China,  Nux,  Cocculus. 

A  good  deal  is  said  about  pneumo-typhus  as  a  par- 
ticular disease,  without  considering  that  the  inflam- 
matory process  in  the  lungs  frequently  takes  place  in 
company  with  the  typhoid,  and  that  the  known  hy- 
postasis,  which  is  going  on  in  the  lower  lobes  of  the 
lungs  in  every  typhoid  disease,  sometimes  increases 
to  a  real  pneumonia,  in  which  case  the  inflammatory 
symptoms  are  more  marked  than  those  which  proper- 
ly belong  to  the  typhoid  process.  The  treatment  is 
the  same  as  that  of  pneumonia  typhosa,  of  which  we 
shall  treat  hereafter. 

As  regards  diet,  the  patient  ought  to  live  on  thin 
gruel,  soups  made  of  salep,  sago,  oat-meal,  &c.,  light 
and  easily  digested  meat,  such  as  pigeons,  capons, 
chicken,  &c.,  light  vegetables,  and  even  bread  and  a 
little  butter,  if  the  patient  should  have  any  desire  for 
it.  The  patient  may  eat  fruit,  raw  and  boiled ;  his 
drink  should  be  boiled  milk,  toast-water  with  a  little 
mulberry,  raspberry,  althea  or  cherry-juice.  The 
patient  may  likewise  drink  buttermilk,  which  will  not 
injure  him  in  the  least.  There  is  scarcely  a  disease, 
where  the  desire  of  the  patient  for  one  or  the  other 
kind  of  food  ought  to  be  regarded  with  more  care, 
than  in  typhus,  especially  if  the  patient  desire  acid 
things.  The  temperature  of  the  room  should  be  the 
same  at  all  times,  rather  cool,  and  the  patient  should 
not  have  too  much  covering.  The  room  should  be 
kept  perfectly  quiet,  as  every  impression,  which  the 
patient  receives  from  without,  tends  to  irritate  his 
brain  and  furnish  new  food  to  his  ravings.  It  is  of 
the  utmost  importance,  that  the  patient  should  be  kept 
clean,  and  the  room  should  be  aired  from  time  to  time, 
without,  however,  exposing  the  patient.* 

*  We  recommend  our  readers  never  to  allow  recovering  typhus  patients 
any  row  fruit ;  for  a  fortnight  after  the  cessation  of  the  fever,  the  diet  should 


252  PUTRID    FEVER. 

§  79.  Typhus  putridus,  febris  putrida.  Fever  with  de- 
composition of  the  animal  matter. 

Typhus  putridus  sometimes  sets  in  as  an  epidemic 
fever ;  in  which  case  it  becomes  a  primary  disease 
\vhich  is  engendered  by  a  putrid  cohtagium ;  most 
frequently,  however,  typhus  putridus  developes  itself 
out  of  an  acute  fever,  and  more  particularly  out  of 
typhus  ;  it  may  likewise  arise  from  every  other  kind 
of  fever,  even  from  an  inflammatory,  by  the  patient 
being  kept  too  hot,  or  in  uncleanliness,  vitiated  air, 
etc.  In  men  who  are  affected  with  some  morbid 
dyscrasia,  the  scorbutic  diathesis,  or  who  have  been 
poisoned  with  Mercury. 

The  fundamental  character  of  typhus  putridus  is  an 
excessive  depression  of  the  vital  forces  with  disposi- 
tion to  putrid  decomposition.  Without  mentioning 
again  the  general  characteristic  symptoms  of  typhus, 
which  are  the  same  in  all  the  varieties  of  that  disease, 
we  will  content  ourselves  with  simply  mentioning 
those  which  belong  to  typhus  putridus  exclusively ; 
they  are  :  quick,  small,  soft,  easily  compressible  pulse ; 
calor  mordax,  the  hand,  wrhen  touching  the  patient, 
experiences  a  disagreeable,  pungent,  burning,  prick- 
ling and  stinging  sensation,  which  increases  as  the 
contact  is  prolonged  and  leaves  a  similar  sensation 
behind  for  some  time  ;  internal  chilliness  occasionally, 
or  shiverings  creeping  over  the  skin;  the  breathing  is 
generally  calm,  no  thirst ;  great  anguish,  despondency, 
indifference,  insensibility.  Characteristic  indications 
are,  likewise:  putrid,  cadaverous  smell  of  the  breath, 
of  the  exhalations  from  the  skin,  and  of  other  secre- 
tions ;  petechise  ;  profuse,  oily,  clammy  sweats  ;  turbid, 
dark  urine,  colliquative  diarrhoea,  hemorrhages  from 
every  orifice  of  the  body,  decubitus,  tendency  to  gan- 
grene ;  the  blood  which  is  evacuated  does  not  decom- 
pose itself  into  cruor  and  serum  like  healthy  blood, 
but  forms  a  pappy  mixture. 

be  extremely  simple,  although  the  patient  need  not  starve  ;  butchers'  meat, 
stimulating  drinks,  potatoes,  celery,  radishes,  and  the  like,  should  not  be 
used.  Some  physicians,  who  are  even  very  clever  in  other  respects,  are  not 
jufSciently  careful  in  regulating  the  diet  of  their  patients. — HEMFEL. 


PUTRID    FEVER.  253 

§  80.  The  treatment  of  these  fevers,  whether  pri- 
mary or  consecutive  diseases,  is  very  seldom  successful. 
The  existing  symptoms  do  not  so  much  point  to 
certain  remedies  as  te  a  decomposition  of  the  fluids 
and  more  particularly  the  blood. 

The  fever  is  not  a  putrid  typhus,  as  long  as  symptoms 
of  decomposition  have  not  made  their  appearance. 
Even  if  the  putrid  state  should  set  in  as  a  primary  dis- 
ease, there  are  precursory  symptoms  denoting  a  gastric, 
bilious,  pituitous,  or  typhoid  state,  and  requiring  a 
treatment  such  as  has  been  indicated  for  those  conditions. 

The  following  remedies  are  principally  indicated 
for  that  variety  of  typhus :  Arsenicum,  Arnica,  Carbo 
veg.  and  anim.  ;  Kreosot,  Acidum  phosp.  and  muriat. ; 
China,  Ipec.,  Mercur.,  Mercur.  dulcis,  Rhus,  Bellad., 
Nux  vom.  and  moschata,  Hyosc.,  Opium,  and  some- 
times perhaps  Camphor  and  Cuprum. 

Arsenic  is  probably  preferable  to  every  other  remedy 
when  the  disease  has  reached  its  worst  stage,  when 
the  patient  complains  of  burning  heat,  great  anguish 
and  restlessness,  when  petechiae,  aphthse  and  profuse 
colliquative  secretions  are  present.  Arnica  may  be  of 
use  when  profuse  and  frequent  hemorrhages  take 
place,  and  great  thirst,  headache,  yellow  countenance 
and  loss  of  appetite  are  present.  The  two  varieties 
of  Carbo  ought  to  be  tried  when  the  blood  is  entirely 
decomposed,  when  stupor  and  raling  are  present,  with 
cold  sweat  of  the  face  and  limbs,  hippocratic  counte- 
nance, small,  scarcely  perceptible  pulse,  great  disten- 
tion  of  the  veins,  and  especially,  if  such  a  fever  occur 
after  the  excessive  use  of  China.  Kreosot  may  be  of 
service  when  the  patient  complains  of  an  excessive 
debility  in  the  limbs,  and  when  a  racking,  painful  cough 
from  the  inmost  parts  of  the  chest  is  present,  ac- 
companied with  a  sensation  of  warmth  which  rises  in- 
to the  throat ;  and  lastly,  when  the  patient  complains 
of  a  painful  pressure  on  the  top  of  the  head  which  is 
aggravated  by  contact.  The  two  acids  correspond 
particularly  to  the  colliquative  stage.  China  is 
indicated  at  the  commencement  of  the  disease  by 
hemorrhages,  yellow  skin  and  countenance,  excessive, 


254  HOSPITAL    FEVER. 

debility  and  pain  in  the  limbs.  Ipec.  and  Hyoac.,  may 
likewise  be  indicated  at  the  commencement  of  the 
disease  when  the  symptoms  which  have  been  describ- 
ed last,  are  accompanied  by  spasms.  Rhus  and  Bella- 
donna are  preferable  to  all  other  remedies  when 
the  nervous  system  is  principally  involved  in  typhus 
putridus.  Opium  should  be  employed  when  the  irri- 
tability of  the  organs  is  entirely  gone,  provided  the 
other  symptoms  correspond.  Nux  is  the  remedy  when 
the  disease  sets  in  with  excessive  debility  and  the 
gastric  and  bilious  symptoms  such  as :  livid  com- 
plexion, bitter  and  putrid  eructations  and  taste,  yellow 
coating  of  the  tongue,  constipation,  are  predominant. 
Nux  moschata  is  more  particularly  indicated  when 
putrid  debilitating  diarrhoea  and  bloody  expectoration 
are  present.  Mercurius  is  to  be  administered  when 
the  nervous  system  is  very  much  excited,  when  there 
is  a  tendency  to  profuse  sweats  and  putrid  decomposi- 
tion, accompanied  with  great  painfulness  of  the  region 
of  the  liver,  the  epigastrium,  and  pit  of  the  stomach. 
Mercurius  dulcis  is  indicated  by  similar  symptoms, 
when  the  process  of  decomposition  has  reached  its 
acme.  We  have  no  other  reason  for  recommending 
Camphor  and  Cuprum  except  that  these  two  remedies 
have  been  employed  with  success  in  Cholera,  from 
which  we  have,  perhaps  wrongly,  inferred  that  they 
might  likewise  prove  useful  in  typhus  putridus. 

§  81.  Typhus  contagiosus,  bellicus.  Hospital  or  jail 
fever. 

This  typhus  is  characterized  by  the  symptoms  of  the 
ordinary  typhus  or  the  typhus  putridus,  and  is  propa- 
gated by  a  contagium.  At  first  it  is  of  an  inflammatory 
character,  the  typhoid  symptoms  only  setting  in  after- 
wards with  tendency  to  exanthema,  whence  the  fever 
is  also  termed  petechial  fever. 

The  treatment  is  pretty  much  the  same  as  that  of 
typhus  and  typhus  putridus.  The  principal  remedies 
in  typhus  petechialis  are  probably  Bryonia,  Rhus,  Ar- 
senicum. 

Dietetic  rules. — Every  contagium  being  increased  by 


YELLOW    FEVER.  255 

excessive  warmth  and  becoming  so  much  more  poison- 
ous as  the  temperature  of  the  sick  room  is  kept  above 
the  proper  standard — the  thermometer  in  a  sick  room 
should  never  be  above  67°  Fahrenheit.  To  have  this 
temperature  in  the  summer  season,  vessels  with  cold 
water  should  be  constantly  kept  in  the  room  and  the 
room  should  be  frequently  sprinkled.  The  patient 
should  rest  upon  a  mattress,  and  should  be  but  lightly 
covered. 

The  patient  must  be  kept  clean ;  the  room  is  to  be 
frequently  aired  and  only  one  patient  should  be  in  a  room 
at  a  time.  The  contagium  is  increased  by  several  patients 
being  confined  in  the  same  room.  Among  the  means 
which  have  been  recommended  for  the  destruction  of 
the  contagium,  the  best  is  undoubtedly  a  frequent  re- 
newal of  air  by  means  of  a  current  passing  through  it ; 
the  patient  has  to  be  guarded  against  that  current,  of 
course. 

§  82.   Typhus  pestilentialis. 

We  know  nothing  of  the  treatment  of  this  disease, 
and  shall,  therefore,  content  ourselves  with  stating  the 
characteristic  symptoms. 

The  pest  is  propagated  by  contact,  never  by  the  air. 
Its  principal  phenomena  are  :  buboes  and  anthrax, 
that  is,  inflammatory  swellings  of  glands,  \vith  ten- 
dency to  gangrene  which  sets  in  with  great  rapidity, 
especially  in  the  axilla  and  the  inguinal  region ;  pe- 
techiee,  ecchymosis,  violent  fever,  anguish,  excessive 
vomiting,  the  brain  is  greatly  involved  ;  all  the  secre- 
tions have  a  putrid  smell  and  the  prostration  of  the 
patient  is  excessive. 

The  following  remedies  might  perhaps  be  proposed 
as  corresponding  more  or  less  to  the  symptoms :  Vera- 
trum,  Arsenic,  Acidum  hydrocyan.,  Lauroc.,  Kreosot, 
Quinine,  Lachesis,  etc. 

§  83.   Typhus  icterodes.     Yellow  fever. 

This  disease  arises  from  some  endemic  miasm.  Its 
symptoms  are  :  yellow  colour  of  the  skin,  violent  vo- 
miting of  black  substances,  black  stools,  great  anguish, 


256  LENTESCENT   TYPHUS. 

debility,  violent  fever.    The  course  of  this  fever  is  very 
rapid. 

The  following  remedies  may  perhaps  be  of  use  ; 
Arsenic,  Digitalis,  China,  Nux,  Crotalus,  Bryonia,  Sul- 
phur, etc. 

§  84.   Typhus  lentus.     Lentescent  typhus. 

This  kind  of  typhus  is  a  primary,  idiopathic  disease, 
which  does  not  depend  upon  any  local  affection,  and 
may  be  occasioned  by  various  causes. 

The  essential  character  of  the  disease  is  great  ner- 
vous debility  and  prostration  of  all  the  functions.  It 
developes  itself  slowly,  sometimes  for  months,  without 
any  inflammatory  symptoms.  Sometimes  it  sets  in  as 
a  sequel  of  an  acute  fever,  inflammatory  typhus  ;  or  it 
may  arise  from  excessive  physical  and  mental  exer- 
tions, venereal  excesses,  onanism,  great  loss  of  blood, 
chronic  hemorrhages,  and  blenorrhoea.  The  symptoms 
of  such  a  fever  are :  small,  quick,  variable  pulse  ; 
changeable  urine  ;  chilliness  and  coldness  more  fre- 
quent than  heat ;  no  sweat,  or  only  evanescent  sweat ; 
cerebral  symptoms  ;  spasms ;  hypochondriac  mood, 
which  is  greatest  in  the  morning  and  before  breakfast, 
when  the  patient  feels  worst ;  the  fever  is  less  after 
dinner,  and  then  the  patient  feels  better ;  these  last 
symptoms  distinguish  the  lentescent  typhus  from  a 
hectic  fever  which  depends  on  local  causes. 
•  §  85.  The  treatment  of  slow  typhus  does  not  essen- 
tially differ  from  that  of  ordinary  typhus.  The  follow- 
ing medicines  will  be  found  the  most  efficient :  Cocc., 
Camph.,  Acid,  phosp.,  Phosphorus,  Lycop.,  Ignat., 
China,  Ipec.,  Arsenic.,  Verat.  alb.,  Plumb.,  Mercur., 
Helleb.  niger,  Digitalis,  Conmm,  Cuprum,  Stannum. 

If  the  disease  arise  from  care  and  chagrin,  a  small 
dose  of  Acidum  phosph.  is  the  most  certain  remedy 
(according  to  Hummel* it  may,  in  that  case,  be  given 
alternately  with  Arsenic)  ;  if  it  arise  from  grief,  one 
or  two  doses  of  Ignat.  18  will  cure  it. 

Cocculus  is  an  excellent  remedy,  if  the  disease  be 
occasioned  by  frequent  vexation  and  irritation  of  tem- 
per ;  the  symptoms  being  as  follows :  frequent  evan- 


LENTESCENT   TYPHUS.  257 

escent  attacks  of  a  disagreeable,  burning  heat,  and 
redness  of  the  cheeks  ;  evening  exacerbations  charac- 
terized by  hot  hands,  sensation  of  dry  heat  all  over  the 
body,  sleeplessness  at  nights ;  or  frequent  shiverings  in 
the  day-time  accompanied  with  great  debility,  so  that 
the  patient  is  obliged  to  lie  down  ;  the  patient  is  very 
sensitive  and  irritable. 

Repeated  doses  of  Camphor  may  be  administered 
when  the  temperature  of  the  skin  is  very  low,  and  the 
patient  is  very  weak  and  not  very  sensible. 

Ipecacuanha  is  undoubtedly  one  of  the  most  distin- 
guished remedies  in  this  disease  ;  it  ought  to  be  re- 
peated frequently. 

Veratrum,  not  too  high,  is  an  excellent  remedy  when 
the  febrile  paroxysm  sets  in  at  times  in  the  evening, 
at  times  in  the  morning,  with  redness  and  heat  of  the 
face,  heat  of  the  hands,  intermingled  with  febrile 
shiverings  and  accompanied  with  great  despondency ; 
between  the  paroxysms  the  body  feels  cold,  and  a  cold 
sweat  makes  its  appearance,  at  least  upon  the  fore- 
head, the  patient  being,  moreover,  very  weak  and 
listless. 

Helleborus  niger  is  indicated  by  the  following 
symptoms  :  constant  chilliness  of  the  whole  body  with 
cold  hands,  burning  heat  internally,  the  head  feels 
dull  and  stupid  ;  the  patient  complains  of  drowsiness, 
heavinesss  and  debility  of  the  feet,  stiffness  of  the  knee- 
joints.  These  symptoms  occur  when  out  of  bed ;  as 
soon  as  the  patient  lies  down  he  feels  hot  and  sweats, 
without  thirst. 

China,  Arsenic,  and  Digitalis,  have  been  mentioned 
in  detail  in  the  chapters  on  typhus. 


258 

SIXTH    CLASS. 
INTERMITTENT    OR    CHRONIC    FEVERS. 

§  86.  Intermittent  fever.  Fever  and  ague.* 
It  is  very  difficult  to  establish  general  rules  for  the 
treatment  of  intermittent  fever.  The  type  of  the  fever, 
the  peculiarities  of  the  chilly  and  hot  stages,  of  the 
sweat  and  thirst,  are  not  the  only  indications  for  the 
selection  of  a  remedy  ;  the  character  of  the  apyrexia 
has  likewise  to  be  considered  and  \vill  differ  in  differ- 
ent patients.  This  is  one  reason  why  we  should  only 
be  able  at  the  bed-side  of  the  patient  to  determine  what 
remedy  we  shall  use  in  the  case.  A  second  reason 
why  the  indication  of  specific  remedies  for  intermittent 
fevers  is  difficult,  is  that  they  rouse,  more  readily  than 
any  other  affection  can  do,  the  dyscrasia  which  may  be 
latent  in  the  system;  this  then  combines  with  the  fever 
and  impresses  upon  it  a  peculiar  character.  There  are 
other  diseases  which  either  set  in  with  or  acquire  an 
intermittent  type  (diseases  where  no  vascular  erethism 
is  present,  but  the  intermittent  character  of  the  disease 
is  evident) ;  in  these  diseases  the  remedy  has  likewise 
to  be  chosen  at  the  bed-side  of  the  patient.  These  and 
similar  difficulties  shall  not  deter  us  from  communi- 
cating the  following  remarks  relative  to  the  treatment 
of  intermittent  fever ;  they  will  perhaps  aid  the  begin- 
ner in  homoeopathy  in  selecting  proper  remedies  for 
the  cases  which  he  may  be  called  upon  to  treat. 

§  87.  Intermittent  fevers  might  be  considered  syno- 
chal  fevers,  inasmuch  as  great  vascular  irritation  is 
present  in  every  case  of  fever  and  ague.  The  differ- 
ence between  those  two  classes  of  fevers  is  simply  this, 
that  a  synochal  fever  has  only  one  paroxysm,  whereas 
an  intermittent  fever  consists  of  a  succession  of  syno- 
chal paroxysms  with  intermitting  type.  This  state- 

*  See  the  excellent  treatise  on  the  treatment  of  intermittent  fever,  by 
Dr.  Hartlaub  in  Hartlaub  and  Trink's  Annals,  Vol.  III.  (This  treatise  will  be 
published  in  one  of  the  next  numbers  of  the  Examiner.) 

See  also  Boennin°;hausen's  treatise  on  the  treatment  of  intermittent  fever, 
translated  by  Charles  J.  Hempel,  M.D.  This  is  a  practical  essay  and  abso- 
lutely necessary  to  a  physician  who  wishes  to  treat  intermittent  fever  with 
.occess. 


INTERMITTENT   FEVER.  259 

ment  only  refers  to  pure  intermittent  fevers  ;  'if  such  a 
fever  should  possess  some  of  the  characters  of  syno- 
chus  or  typhus,  it  belongs  to  the  class  of  complicated 
intermittent  fevers,  for  which  it  is  much  easier  to  dis- 
cover a  specific  remedy  than  for  simple  fevers  of  that 
class. 

An  intermittent  fever  is  recognised  and  its  character 
determined  by  the  periodicity  of  the  paroxysms  and 
the  intermissions,  the  only  two  essential  and  charac- 
teristic phenomena  in  intermittent  fever.  The  parox- 
ysms and  the  intermissions  themselves  are  so  various 
that  it  is  impossible  to  give  a  detailed  account  of  the 
symptoms.  In  some  fevers  the  paroxysms  consist 
merely  of  heat ;  in  others  of  coldness,  with  or  without 
subsequent  sweat ;  there  are  fevers  with  coldness  all 
over  the  body,  the  patient  nevertheless  feeling  hot  to 
himself,  or  he  experiences  chilliness  although  the  skin 
is  hot  to  the  touch ;  there  are  fevers  where  one  parox- 
ysm consists  of  a  mere  chill  or  coldness  followed  by  a 
feeling  of  health,  the  other  of  heat  followed  by  sweat 
or  without  sweat ;  in  some  fevers  the  heat  comes  first 
and  the  chilliness  afterwards  ;  in  others  the  chilliness 
and  heat  are  followed  by  a  long  intermission,  after 
which  sweat  breaks  out,  which  may  be  considered  in 
the  light  of  a  second  paroxysm ;  there  are  fevers 
where  no  sweat  is  present,  others  again  where  sweat 
constitutes  the  paroxysm  \vithout  heat  or  chilliness,  or 
where  the  sweat  is  only  present  during  the  heat. 
There  are  many  more  peculiarities,  especially  as  re- 
spects the  accompanying  symptoms,  headache,  bad 
taste,  nausea,  vomiting,  diarrhosa,  absence  of  thirst  or 
else  violent  thirst,  pains  in  the  bowels  and  limbs,  sleep, 
delirium,  temper,  spasms,  etc.,  before,  during,  or  after 
the  chilliness,  heat,  or  sweat,  not  to  speak  of  a  number 
of  other  characteristic  differences.  The  characteristic 
appearances  of  the  intermission  should  not  be  neglected 
by  the  physician,  particularly  if  the  paroxysm  should 
not  be  well  marked,  in  which  case  the  apyrexia  will 
be  characterized  by  symptoms  which  do  not  generally 
exist  after  a  paroxysm. 

The  general  symptoms  of  fever  and  ague  are  :  chil- 


260  INTERMITTENT   FEVER. 

liness,  heat,  and  sweat,  recurring  at  regular  or  irregu- 
lar periods,  followed  by  the  appearance  of  a  red, 
brick-dust  sediment  in  the  urine  ;  during  the  apyrexia 
the  patient  feels  more  or  less  comfortable  and  the 
pulse  is  normal.  Most  frequently  the  paroxysms  recur 
at  regular  periods,  every  twenty-four  hours  (quotidia- 
nae), forty-eight  (tertianae),  seventy-two  (quart anae)> etc. 

We  know  very  well  that  modern  pathologists  do  not 
number  intermittent  fevers  among  the  febrile  diseases. 
Various  affections  may  be  distinguished  by  a  regular 
intermittent  type  without  having  a  febrile  character. 
Such  intermittent  diseases  originate  in  the  peripheral 
nerves,  not  the  vascular  system,  which  is  affected 
secondarily  on  account  of  the  intimate  relation  existing 
between  those  nerves  and  the  blood-vessels  ;  hence  it 
is  that  intermittent  diseases  are  now  termed  gangli- 
onic,  cerebral  or  spinal  intermittent.  Nevertheless 
we  have  preferred  treating  this  class  of  diseases  as 
usual,  pointing  out  their  characteristic  peculiarities  as 
much  as  was  necessary  and  occupying  ourselves 
principally  with  their  homoaopathic  treatment. 

The  duration  of  an  intermittent  fever  is  very  un- 
certain, from  one  week,  to  several  weeks  or  even 
months.  In  no  disease  there  is  a  greater  disposition 
to  relapses  than  in  intermittent  fevers  ;  in  a  quotidian 
a  relapse  takes  place  on  the  seventh  day,  in  a  tertian 
on  the  fourteenth,  in  a  quartan  on  the  twenty-eighth 
after  the  cessation  of  the  last  paroxysm.  A  relapse 
may  be  anticipated  if  a  feverish  feeling  should  remain 
in  the  system  ;  if  the  feverish  colour  should  remain  on 
the  cheeks  ;  if  the  strength  of  the  patient  should  not 
increase  with  his  appetite  ;  if  the  last  paroxysm  should 
be  like  the  first ;  if  at  the  time  when  the  paroxysms  used 
to  occur,  slight  chills,  a  drawing  and  stretching  of  the 
limbs,  continual  yawning,  irritated  pulse,  changeable 
urine,  should  make  their  appearance.  Relapses  are 
frequently  brought  on  by  moral  causes,  slight  errors 
in  diet,  by  eating  milk,  eggs,  fish,  etc.  ;  by  changes  of 
temperature,  walking  along  the  water,  continual  use 
of  cold  drinks,  etc. 

An  intermittent  fever  is  not  of  itself  a  dangerous 


INTERMITTENT  FEVER.  261 

disease,  but  it  may  become  so  by  concomitant  symp- 
toms ;  a  long  duration  of  the  fever  may  occasion  a 
peculiar  cachectic  state,  dropsy,  nervous  affections, 
etc. 

Exciting  causes  are  :  low  marshy  regions,  stagnant 
waters  ;  atmospheric  miasmata  occasioning,  epidemic 
intermittent  fevers ;  colds  and  wet  skin,  lying  upon  a 
cold  soil  or  floor ;  excessive  use  of  cold  water,  heavy 
dishes  of  flour,  acid  fruit  containing  a  good  deal  of 
water,  fish. 

§  88.  It  is  important  to  give  the  remedy  immediately 
after  the  paroxysm.  If  the  apyrexia  should  be  very 
short  or  some  of  the  symptoms  of  the  paroxysm  should 
remain  during  the  apyrexia,  the  medicine  should  be 
administered  when  the  sweat  commences  to  abate  or 
the  symptoms  which  usually  appear  in  the  wake  of  a 
paroxysm  begin  to  disappear.  It  is  likewise  expedient 
to  repeat  the  homoeopathic  specific  a  few  hours  before 
the  next  paroxysm. 

The  treatment  of  intermittent  fevers  is  not  as  easy 
as  it  \vould  seem  at  first  sight ;  every  case  of  inter- 
mittent fever  has  to  be  examined  independently  of  any 
other  case,  for  this  reason,  that  almost  every  case 
differs  from  the  other,  even  in  an  epidemic  intermittent. 
In  every  case  of  intermittent  fever  the  character  of  the 
chills,  heat  and  thirst  (not  so  much  the  sweat)  has  to 
be  minutely  inquired  into  ;  next  to  that  the  concom- 
itant symptoms  and  the  symptoms  of  the  apyrexia, 
especially  those  which  remain  from  the  paroxysm. 
The  type  scarcely  ever  determines  the  selection  of  the 
homoeopathic  agent,  since  any  type  can  be  controlled 
by  it,  provided  it  is  otherwise  homoeopathic  to  the 
symptoms.  Puls.,  Ipec.,  Nux,  etc.  are  most  suitable 
to  quotidian,  and  Arsenic  to  quartan  intermittent 
fevers  ;  still  they  will  remove  fevers  with  any  other 
type,  provided  the  symptoms  correspond. 

A  writer  in  the  Archiv  advises  in  some  fevers  to 
give  four  doses  of  Ipec.  at  equal  intervals,  and  a  dose 
of  Nux  in  the  next  apyrexia. 

The  endemic  intermittent  fevers  of  marshy  regions 
are  most  speedily  removed  by  a  few  doses  of  China, 


262  INTERMITTENT   FEVER. 

higher  potencies.  If  this  kind  of  fever  should  not 
yield  to  China  in  persons  who  have  sufficient  exercise 
and  otherwise  live  carefully,  the  cause  is  to  be  found 
in  the  psora  having  become  roused  from  its  latent 
state  ;  all  such  cases  require  an  antipsoric  treatment. 

Some  very  experienced  homosopathic  physicians 
administer  a  few  doses  of  Aconite,  higher  potencies,  a 
few  hours  previous  to  the  paroxysm  if  it  be  violent. 
This  proceeding  is  not  irrational,  as  every  paroxysm 
partakes  more  or  less  of  the  character  of  a  synochal  or 
erethic  fever  and  is  most  readily  controlled  by  Aconite. 

The  principal  remedies  against  intermittent  fever 
are :  China,  Quinine,  Ars.,  Verat.,  Arnica,  Ant.  cr., 
Nux,  Bell.,  Cocc.,  Caps.,  Carbo  veg.  and  anim.,  Can- 
thar.,  Ignat.,  Lach.,  Puls.,  Sabad.,  Sepia,  Dig.,  Bryo., 
Dros.,  Dulc.,  Natr.  mur.,  Lye.,  Staphys.,  Sulph.,  etc. 

China  corresponds  more  or  less  to  the  following 
symptoms  ;  no  thirst  during  the  chilly  stage,  thirst  be- 
tween the  chilly  and  hot  stage  ;  China  is  not  suitable 
when  thirst  is  present  in  the  hot  stage ;  if  thirst  be 
present  during  the  hot  stage  of  a  China-intermittent, 
the  heat  ought  simply  to  be  a  burning  or  dryness  of 
the  lips  which  require  moistening,  but  no  real  thirst  is 
experienced  by  the  patient.  If  the  thirst  set  in  after 
the  heat,  or  during  the  sweaty  stage,  China  is  the 
remedy.  China  corresponds,  if  the  fever  should  com- 
mence with  a  secondary  symptom,  such  as  :  palpitation 
of  the  heart,  anxiety,  frequent  sneezing,  nausea,  great 
thirst,  canine  hunger,  oppressive  pain  in  the  abdomen 
or  head  ;  or  if  the  veins  should  become  distended  when 
the  head  feels  hot,  or  when  the  temperature  of  the 
body  is  slightly  raised,  or  when  the  patient  merely 
feels  hot  to  himself  and  not  to  others,  or  when  the  skin 
feels  hot  to  others.  China  is  moreover  indicated  by 
congestion  of  blood  to  the  head,  redness  and  heat  of 
the  face,  generally  accompanied  with  chilliness  and 
coldness  to  the  touch  of  the  extremities,  or  by  heat  of 
the  face  "which  is  perceptible  only  to  the  patient,  the 
face  feeling  cold  to  the  hand,  with  cold  sweat  on  the 
forehead. 

Nux,  together  With  Verat.,   Bryo.,  Bellad.,   Coc., 


INTERMITTENT   FEVER.  263 

Puls.,  deserves  consideration  when  the  bowels  are  con- 
fined, or  when  gastric  or  bilious  symptoms  make  their 
appearance  in  consequence  of  gross  errors  in  diet ;  or 
when  nervous  symptoms  set  in  in  consequence  of  the 
spinal  marrow  being  more  or  less  irritated.  Nux  has 
so  far  proved  most  useful  in  quotidian  and  tertian 
fevers,  which  make  their  appearance  in  the,  afternoon, 
evening  or  night,  consisting  of  alternate  chilliness  and 
heat,  with  great  desire  for  beer ;  aching  pain  in  the 
forehead,  vertigo,  nausea,  bitter  taste  and  eructations, 
spasms  of  the  stomach,  great  weakness,  all  these 
symptoms  setting  in  even  at  the  commencement  of  the 
paroxysm.  In  intermittent  fevers,  accompanied  with 
bilious  and  gastric  symptoms,  Cham.,  Ant.  cr.,  and 
Puls.  are  on  a  par  with  Nux,  (see  the  chapter  on  bili- 
ous and  gastric  fevers).  Nux  is  highly  important  in 
some  kinds  of  the  so-called  apoplectic  intermittent 
fevers,  with  vertigo,  anguish,  feverish  shiverings,  a 
peculiar  kind  of  delirium,  consisting  of  vivid  and  some- 
times frightful  visions,  and  occasioning  a  tightness  in 
the  region  of  the  stomach,  typhoid  and  febrile  symp- 
toms being  intermingled.  Nux  will  prove  serviceable 
in  fevers  where  the  following  symptoms  set  in  in  the 
very  commencement  of  the  attack :  paralytic  weak- 
ness of  the  limbs,  debility  in  the  knees  and  feet,  exces- 
sive weariness,  tremor,  sudden  failing  of  strength, 
swoons,  vertigo,  with  vanishing  of  the  senses,  giddi- 
ness and  weight  of  the  head  as  in  a  state  of  intoxica- 
tion, desire  to  lie  down  ;  troublesome,  anxious  breath- 
ing, palpitation  of  the  heart,  fear  of  death,  qualmishness, 
shiverings,  followed  by  anxiety  and  warmth ;  warm 
cheeks,  with  internal  shiverings ;  the  face  feels  hot, 
with  shiverings  over  the  rest  of  the  body  ;  heat  in  the 
head,  with  coldness  of  the  body  ;  burning  in  the  eyes, 
without  any  inflammation  being  present ;  tearing,  beat- 
ing, stinging  headache,  increased  by  walking,  and  by 
the  open  air  ;  loss  of  appetite,  aversion  to  bread  ;  bitter 
and  sour  eructations  ;  fancies  in  the  night  in  a  state  of 
half  sleeping  or  waking  ;  furious  delirium  ;  burning, 
itching  rash,  and  a  burning  itching  of  the  whole  body. 
The  exhibition  of  Belladonna  depends,  like  that  of 


264  INTERMITTENT    FEVER. 

Nux,  more  upon  the  concomitant  symptoms  than  upon 
the  character  of  the  paroxysm  itself.  Belladonna 
being  a  great  remedy  for  diseases  which  return  peri- 
odically, it  must  be  of  great  use  in  curing  the  regu- 
larly recurring  painful  paroxysms  of  fever  and  ague, 
where  the  chilliness  is  but  slight,  the  heat  is  sometimes 
accompanied  with  chills,  sweat  and  thirst  are  moderate, 
and  the  patient  drinks  merely  for  the  purpose  of  re- 
lieving the  dryness  of  his  mouth  and  fauces.  Bella- 
donna is  sometimes  suitable  in  a  quotidian  intermittent, 
when  the  paroxysms  are  accompanied  \vith  the  follow- 
ing symptoms :  violent  headache,  with  vertigo  ;  hallu- 
cinations, redness  of  the  eyes,  nausea,  vomiting, 
constipation,  chills,  or  simple  chilly  creeping  over  the 
skin,  with  thirst  without  any  considerable  heat  after- 
wards, moderate  increase  of  the  temperature  of  the 
skin,  sweat.  Bellad.  deserves  consideration  in  fevers 
of  long  standing,  or  in  those  which  had  been  suppressed 
by  Quinine  and  have  returned  afterwards,  with  swell- 
ing of  the  liver  and  spleen,  incipient  dropsy,  derange- 
ment of  the  digestive  powers,  and  violent  headache 
during  the  paroxysm. 

Veratrum  is  useful  in  fevers  consisting  simply  of 
external  coldness,  or  mere  internal  heat,  with  dark 
urine  ;  or  when  a  warm  sweat  is  present  all  over  the 
body,  or  only  on  the  forehead,  which  soon  becomes 
cold,  and  is  accompanied  with  vertigo,  nausea,  exces- 
sive pain  in  the  small  of  the  back  and  back. 

Cina,  tincture,  is  the  best  remedy  for  fevers,  com- 
mencing with  vomiting  of  food,  and  subsequent  canine 
hunger  ;  or  where  the  chilliness  is  accompanied  with 
thirst. 

Fevers,  where  vomiting  of  mucus  is  present  during 
the  cold  stage,  with  moderate  thirst  both  in  the  hot  and 
sweaty  stage,  mucous  stools  in  the  apyrexia,  with  con- 
stant nausea  and  loss  of  appetite,  are  cured  by  Pulsa- 
tilla.  Antimonium  cr.  is  closely  related  to  Puls. ;  it  is 
particularly  distinguished  when  the  sweat  sets  in  with 
the  heat  and  disappears  speedily,  dry  heat  remaining, 
with  constant  thirst  and  various  gastric  symptoms, 
such  as  :  want  of  appetite,  eructations,  nausea,  aver- 


INTERMITTENT   FEVER.  265 

sion  to  food,  vomiting,  coated  tongue,  bitter  taste,  tight- 
ness and  pressure  in  the  stomach,  pain  in  the  chest. 

Cocculus  removes  fevers  with  the  following  symp- 
toms in  the  apyrexia :  obstinate  constipation,  spasms 
of  various  kinds,  especially  of  the  stomach,  paralytic 
weakness  of  the  small  of  the  back. 

Arsenic  is  a  great  remedy  in  intermittent  fevers, 
when  neither  the  chilliness  nor  the  heat  are  well 
marked,  or  they  appear  alternately  or  simultaneously ; 
or  when  the  heat  is  burning  and  unpleasant  even  to 
the  hand,  accompanied  with  anguish,  great  restlessness, 
and  an  unquenchable  thirst ;  or  when  the  chilliness  sets 
in  principally  in  the  afternoon  or  evening,  followed  by 
dry  heat  at  night  or  towards  morning,  then  sweat. 
Arsenic  is  the  best  remedy  when  at  the  time  of  the 
paroxysms  unimportant  existing  symptoms  become 
much  more  violent,  or  when  those  symptoms  set  in 
previous  to  the  paroxysm,  or  when  symptoms  appear 
during  the  paroxysm  which  do  not  seem  to  belong  to  it, 
such  as :  violent  anguish,  buzzing  in  the  ears,  tearing  in 
the  bones  and  limbs,  tremor  in  the  limbs,  paralysis,  syn- 
cope, etc.  The  chilly  stage  is  preceded  by  ill  feeling 
through  the  whole  body,  with  stretching  of  the  limbs  and 
drawing  in  the  same  ;  yawning,  debility,  inclination  to 
lie  down,  headache,  vertigo  with  stupefaction,  confused 
feelings  in  the  head,  with  inability  to  collect  one's 
senses.  Between  the  chilly  and  the  hot  stage,  the  fol- 
lowing symptoms  make  their  appearance  :  debility  and 
sleep ;  vertigo,  thirst,  hickup,  anxiety,  nausea,  vomiting 
of  bile,  diminution  of  the  pains.  During  the  apyrexia  : 
hickup,  pressure  in  the  forehead  and  temples,  with 
frightful  dreams ;  bruised  feeling  in  the  limbs. 

Arsenic  is  moreover  suitable  in  fevers  with  the  fol- 
lowing symptoms  :  inclination  to  vomit,  or  bitter  taste 
during  the  chills ;  no  taste,  or  the  taste  is  not  con- 
stantly bitter  and  spurious,  the  bitterness  existing  only 
for  a  short  while  during  or  immediately  after  a  meal ; 
excessive  vertigo,  nausea,  tremor,  sudden  prostration 
of  strength  ;  frequent  drinking,  but  little  at  a  time  ;  the 
sweat  sets  in  a  little  while  after  the  heat,  or  not  at  all ; 
intolerable  pains  and  anguish  about  the  heart. 
12 


266  INTERMITTENT    FEVER. 

Bryonia  corresponds  to  quotidian  and  tertian  fevers, 
whose  paroxysms  set  in  early  in  the  morning,  preceded 
by  vertigo,  oppression  and  pressing  pain  in  the  fore- 
head, coldness  and  chilliness  being  more  prominent 
than  heat ;  thirst  during  the  chilly  and  hot  stage,  dry 
cough,  with  stinging  in  the  chest,  asthma,  nausea,  and 
gagging,  pale  countenance. 

Ipecacuanha  will  be  found  useful  when  the  chilly 
stage  is  moderate  and  short,  the  heat  is  very  great,  and 
thirst  is  present  only  during  the  cold  stage  ;  the  heat 
is  frequently  perceived  only  about  the  head,  in  which 
case  the  cheeks  are  red,  accompanied  with  dilatation 
of  the  pupils,  feeling  of  mental  and  bodily  prostration, 
and  constrictive  tightness  of  the  chest. 

Opium  is  useful  in  soporous  intermittent  fevers,  char- 
acterized by  snoring,  convulsive  movements  of  the 
limbs,  constipation,  warm  sweat. 

Sabadilla  corresponds  to  fevers  of  any  type  which 
set  in  at  the  same  hour,  without  either  anticipating  or 
postponing  ;  the  chilly  stage  is  short,  followed  by  thirst, 
then  heat,  or  the  fever  consists  of  mere  coldness  ;  during 
the  apyrexia  a  slight  chilliness  is  constantly  present,  a 
troublesome,  oppressive  distention  of  the  stomach, 
with  want  of  appetite  ;  nightly,  dry  cough,  pains  in  the 
chest,  violent  oppression  of  breathing. 

Ignatia  is  suitable  to  any  type,  and  corresponds  to 
the  following  symptoms  :  the  coldness  yields  to  external 
warmth,  or  some  parts,  are  hot,  others  cold,  chilly  and 
shivering,  or  the  heat  is  merely  on  the  skin,  without 
thirst ;  thirst  during  the  chilly,  but  not  the  hot  stage  ; 
or  the  paroxysm  is  accompanied  by  dulness  and  con- 
fusion of  the  head ;  pains  as  if  bruised  in  the  right 
side  of  the  occiput,  pressure  in  the  pit  of  the  stomach, 
great  debility,  pale  countenance  ;  dry,  chapped  lips, 
white  tongue,  deep  sleep,  with  snoring,  nettle-rash, 
appearance  of  the  thirst  after  the  fever. 

If  the  continuance  of  the  fever  depend  upon  a  roused 
psora,  Carbo  veg.  will  prove  useful  when  the  following 
symptoms  are  present :  previous  to  the  paroxysm — 
throbbing  in  the  temples,  tearing  in  the  teeth  and  bones, 
stretching  of  the  limbs,  cold  feet ;  during  the  chills — 


INTERMITTENT    FEVER.  267 

thirst,  blue  nails,  great  debility ;  during  the  heat — 
sweat,  absence  of  thirst,  headache,  vertigo,  red  face, 
obscuration  of  sight,  nausea,  pain  in  the  stomach,  ab- 
domen or  chest ;  oppression  of  the  chest,  pain  in  the 
lower  limbs ;  the  headache  continues  a  long  while  after 
the  fever.  Carbo  veg.  is  most  suitable  to  tertian  fevers, 
but  it  has  likewise  been  employed  with  advantage  in 
quotidian  and  quartan  fevers,  and  in  fevers  which  re- 
appear after  having  been  suppressed  by  large  doses  of 
China. 

Caps,  is  related  to  Carb.  v.,  and  may  be  administered 
in  quotidian  and  tertian  fevers,  and  in  fevers  recurring 
after  an  abuse  of  China,  the  following  symptoms  being 
present :  prevalence  of  the  chilly  stage,  during  which 
the  patient  is  tormented  by  great  thirst,  there  is  no 
thirst,  or  only  very  little,  during  the  hot  stage,  heat 
and  sweat  appear  together.  During  the  chilliness  the 
patient  complains  of  anxiety,  restlessness,  inability  to 
collect  the  senses,  intolerance  of  noise,  headache,  pty- 
alism,  vomiting  of  mucus,  painful  swelling  of  the 
spleen,  pain  in  the  back,  tearing  in  the  limbs,  and  con- 
traction of  the  same  ;  stinging  in  the  head  during  the 
hot  stage,  accompanied  with  bad  taste  in  the  mouth, 
cutting  colic,  with  ineffectual  urging,  pain  in  the  chest 
and  back,  tearing  in  the  limbs. 

Natrum  mur.  is  suitable  to  the  same  class  of  fevers 
as  Carbo  and  Capsicum.  They  are  characterized  by 
pains  in  the  bones,  pain  in  the  back,  headache,  great 
debility,  yellow,  livid  complexion,  bitterness  in  the 
mouth,  ulceration  of  the  corners  of  the  mouth,  loss  of 
appetite,  pressure  in  the  pit  of  the  stomach,  with  pain- 
ful sensitiveness  to  contact.  The  chilly  stage  is  more- 
over characterized  by  shortness  of  breath,  yawning, 
drowsiness,  thirst ;  thirst  during  the  heat,  with  a  good 
deal  of  violent  headache. 

Rhus  is  a  remedy  for  fevers  which  arise  from  the 
skin  having  got  wet  in  a  shower.  The  paroxysm  it- 
self is  not  characterized  by  any  remarkable  symptoms ; 
the  accompanying  symptoms,  however,  are  of  import- 
ance, such  as  :  convulsions,  tingling  in  the  ears,  hard- 


268  INTERMITTENT   FEVER. 

ness  of  hearing,  dry  coryza,  sleeplessness  with  rest- 
lessness and  tossing  about,  thirst  at  night,  nettle-rash, 
gastric  symptoms.  The  chilliness  is  sometimes  cha- 
racterized by  pains  in  the  limbs,  headache,  vertigo,  in- 
clination to  vomit. 

Chamomilla,  Mezereum,  Sulphur,  Sepia,  Tartar 
emet.,  etc.,  are  likewise  suitable  to  the  cure  of  inter- 
mittent fevers,  the  latter  remedy  particularly  when 
sopor  is  present  during  the  paroxysm. 

We  will  conclude  this  chapter  with  the  description 
of  a  few  cerebral  symptoms,  recurring  at  regular  in- 
tervals. There  is  a  peculiar  kind  of  headache  which 
is  felt  in  the  morning  after  waking  ;  upon  rising  it  be- 
comes centred  in  the  right  frontal  protuberance,  in- 
creases to  a  pressing  burning,  as  of  an  incandescent 
coal ;  it  extends  down  to  the  eye,  and  about  noon  it 
has  become  so  violent  that  the  patient  has  to  lie  down. 
The  pain  diminishes  after  11  o'clock,  and  the  patient 
feels  entirely  well  again  at  1.  This  headache  yields 
to  one  or  two  doses  of  Carbo  veg. 

A  headache  on  one  side  of  the  head,  which  recurs 
every  three  days,  with  excessive  sensitiveness  of  the 
scalp  in  the  morning,  commencing  with  a  feeling  of 
coldness  in  the  limbs,  and  preceded  by  sleeplessness 
and  general  sweat,  yields  to  pretty  large  doses  of 
Quinine,  one  every  three  or  four  hours. 

Repeated  doses  of  Bellad.  2,  3,  will  remove  a  head- 
ache which  seems  to  be  seated  in  the  glabella,  and 
feels  like  on  oppressive  weight ;  it  is  aggravated  by 
meditating  and  fixing  one's  attention,  the  vessels  in 
that  region  become  distended,  the  place  itself  becomes 
red,  an  inability  to  collect  one's  senses,  languor  of  the 
mind,  and  complete  aversion  to  life  supervene  ;  these 
symptoms  disappear  by  keeping  perfectly  quiet,  and  in 
the  afternoon  the  patient  feels  well,  and  the  mind  is 
easy.* 

Tartaricum  emet.  is  a  good  remedy  in  intermittent 
fevers  when  the  paroxysm  is  accompanied  with  sopor ; 

*  Spigelia  is  a  specific  for  an  aching  over  the  eye,  with  soreness  of  the 
eyeball.  I  have  cured  such  headaches,  even  when  of  years'  standing,  with 
ft  few  doses  of  the  first  attenuation. — HEMFEL. 


INTERMITTENT   FEVER.  269 

also  Chamomilla,  Spongia,  and  Plumbum.  If  a  psoric 
miasm  should  have  been  roused  by  the  fever,  compli- 
cating the  fever,  and  rendering  it  very  obstinate,  the 
antipsorics  have  to  be  employed  against  it :  Tinct. 
sulp.,  Lycop.,  Amm.  mur.,  Calc.  carb.,  Sepia,  Calc. 
sulph.  (Hep.  sulph.),  and  others. 

§  89.  China  cachexia. 

A  China  cachexia  is  an  intermittent  fever  which 
has  been  treated  with  large  doses  of  Quinine,  without 
getting  well,  and  has  become  complicated  with  the 
symptoms  of  a  China  poisoning. 

A  China  cachexia  requires  the  greatest  discretion 
and  circumspection  on  the  part  of  the  physician.  It  is 
a  threefold  complication  of  disease  :  the  original  fever 
which  is  scarcely  yet  recognizable,  the  morbid  dis- 
position originally  existing  in  the  organism,  and  having 
become  roused  by  the  fever,  and  the  poisoning  by  the 
drug.  The  first  thing  to  be  done  is  to  remove  as  much 
as  possible  the  effects  of  the  China,  in  order  to  obtain 
a  distinct  image  of  the  original  disease.  Those  effects 
cannot  be  expected  to  disappear  entirely,  because  they 
are  too  intimately  interwoven  with  the  symptoms  of  the 
roused  psora.  Nevertheless,  the  remedies  have  to  be 
chosen  with  a  direct  view  of  eradicating  the  effects  of 
the  China  from  the  system.  Among  those  remedies 
the  true  antidotes  to  China  are  the  first  to  be  used. 

One  of  the  first  remedies  against  a  China  cachexia 
is  Belladonna,  especially  when  the  following  symp- 
toms prevail :  extreme  sensitiveness  and  irritability  of 
the  nerves,  langour  of  body  and  soul,  excessive  sensi- 
tiveness to  the  least  noise,  and  to  impressions  of  any 
kind  received  through  the  senses  ;  tremulous  weakness 
in  all  the  limbs,  dilatation  of  the  pupils,  dim  eyes, 
which  are  surrounded  with  blue  margins ;  bloated, 
livid  countenance,  yellow  tinge  of  the  whites  of  the 
eyes :  tearing  headache,  which  returns  at  regular 
periods,  and  affects  the  nerves  very  deeply  ;  it  is  espe- 
cially felt  in  the  temples,  and  is  reproduced  or  aggra- 
vated by  the  least  noise  ;  great  debility  and  drowsiness, 
without  being  able  to  sleep  ;  or,  if  sleep  should  set  in, 


270  INTERMITTENT    FEVER. 

it  is  a  restless  kind  of  sleep,  disturbed  with  anxious 
frightful  dreams,  or  by  paroxysms  of  real  anguish,  or 
by  sudden  flushes  of  heat.  The  nervous  erethism 
manifests  itself  particularly  by  a  moaning,  anxious 
and  oppressed  breathing.  An  absence  of  irritability, 
especially  in  the  muscular  fibres  of  the  intestinal 
canal,  as  indicated  by  constipation,  is  no  counter  indi- 
cation for  Belladonna.  A  characteristic  indication  for 
Belladonna  is  the  following  symptom,  when  arising 
from  an  abuse  of  China  :  distention  of  the  abdomen, 
especially  in  the  region  of  the  transverse  colon,  wrhich 
protrudes  like  a  pad,  and  is  very  painful. 

A  second  important  antidote  to  China  is  Ferrum. 
It  is  indicated  by  congestion  of  the  head,  distention  of 
the  veins,  heaviness  of  the  head,  and  a  beating,  ham- 
mering headache  ;  livid,  jaundiced  complexion  ;  bloat- 
edness  of  the  face,  especially  the  eyes  ;  pressure  in  the 
abdomen  and  stomach  from  the  least  nourishment ; 
tension  of  the  abdomen  under  the  ribs,  and  especially 
in  the  right  hypochondrium,  causing  asthmatic  suffer- 
ings and  anxiety ;  vomiting  of  food,  want  of  animal 
heat,  paralytic  weakness  of  the  whole  body,  or  of  parts 
of  the  body. 

All  these,  and  the  following  remedies,  may  in  almost 
all  cases  be  preceded  by  a  few  doses  of  Ipec.  at  inter- 
vals of  two  or  four  hours,  or  by  Arnica,  except  when 
well  marked  and  characteristic  symptoms  should  re- 
quire the  immediate  exhibition  of  some  other  antidote. 

Veratrum  album  antidotes  the  coldness  of  body  and 
the  cold  sweats  produced  by  China,  provided  all  the 
other  symptoms  correspond. 

Pulsatilla  may  be  given  under  the  following  circum- 
stances :  the  food  tastes  bitter,  the  taste  is  otherwise 
natural  and  correct ;  the  fever  generally  comes  on  in 
the  evening,  and  is  accompanied  with  the  following 
symptoms  :  pale  countenance,  vertigo,  with  stupefac- 
tion, painfulness  and  heaviness  of  the  head ;  painful 
oppression  of  the  chest,  moist  cough,  vomiting  of 
mucus,  diarrhoBa,  sopor.  Arsenic  is  to  be  resorted  to 
when  the  febrile  paroxysms  are  not  very  violent,  when 
the  coldness  is  less  marked  than  the  heat,  which  is 


IXTERMITTEXT    FEVER.  271 

burning  and  of  long  duration,  without  much  sweat, 
and  when  other  painful  symptoms  were  either  present 
before  the  paroxysm  and  are  aggravated  by  it,  or 
supervene  during  the  paroxysm.  Scarcely  any  remedy 
is  more  efficient  in  removing  secondary  paroxysms  of 
fever  than  Arsenic,  although  other  medicines  may  seem 
to  be  indicated  by  the  symptoms.  The  higher  poten- 
cies of  Arsenic  are  hot  as-  efficient  as  the  lower  for 
such  purposes ;  we  have  found  the  tincture  of  Arsenic 
the  most  adapted  to  our  use.* 

Staphysagria  cures  fevers  which  reappear  after 
having  been  suppressed  by  Quinine,  when  the  follow- 
ing symptoms  occur :  the  cold  stage  comes  on  in  the 
evening,  without  any  subsequent  heat,  and  accom- 
panied with  scorbutic  symptoms. 

Sulphur  is  indicated  when  the  well-selected  remedies 
do  not  act,  and  this  want  of  action  manifestly  depends 
upon  an  excited  psora.  These  fevers  generally  have 
an  irregular  type,  are  accompanied  with  great  ereth- 
ism of  the  circulation,  distention  of  the  veins  of  the 
hand,  slight  convulsive  jerks  in  the  limbs,  all  these 
symptoms  appearing  mostly  at  night. 

Lachesis  has  been  recommended  in  China  fevers 
with  any  type,  especially,  however,  quartan,  setting 
in  with  twitchings  during  the  chilly  stage,  and  thirst 
during  the  heat.  Secondary  symptoms  are  :  drawing 
in  the  back  and  extremities,  loss  of  appetite,  vomiting, 
hickup,  anxiety  and  uneasiness,  as  from  apprehension 
of  some  accident,  violent  headache,  deep  breathing, 
moaning,  etc. 

Calcarea  may  be  given  for  the  same  symptoms  as 
Sulphur,  especially  when  occurring  in  young,  plethoric 
subjects,  children  and  delicate  women. 

§  90.  There  are  other  drug-diseases  besides  those  of 

*  This  may  be  true,  and  yet  I  recollect  a  case  of  fever  which  had  heen 
treated  for  four  months  in  succession,  in  the  New- York  Hospital,  with  large 
doses  of  Calomel,  Quinine,  blisters,  emetics,  and  the  whole  host  of  allopathic 
deviltry,  without  the  least  benefit  to  the  patient,  and  which  I  cured  with  two 
doses  of  Arsenic,  18.  The  symptoms  were  :  violent  chills,  with  bilious  vomit- 
ing and  tearing  in  the  limbs  ;  burning  heat  of  the  skin,  burning  tongue  and 
mouth,  unquenchable  thirst,  sensation  as  if  fire  were  coursing  through  the 
veins  and  epigastrium,  anguish,  horrid  hammering  in  the  temples,  profuse 
sweats,  debility,  etc. — HEMPEL. 


272  INTERMITTENT    FEVER. 

China.  Such  diseases  may  be  caused  by  the  abuse  of 
natural  and  artificial  mineral  waters,  either  when  used 
as  baths  or  drinks ;  by  the  external  as  well  as  the  in- 
ternal use  of  the  mercurial  preparations ;  Opium, 
Valerian,  Digitalis,  and  others.  These  artificial  dis- 
eases can  only  be  removed  by  the  antipsorics.  In 
treating  diseases  which  are  complicated  by  drug  symp- 
toms, the  physician  ought  to"  commence  the  treatment 
by  antidoting  the  most  prominent  of  the  latter  symp- 
toms ;  to  accomplish  this,  now  one,  now  the  other 
medicine  will  have  to  be  used,  according  as  the  symp- 
toms which  require  to  be  antidoted  can  be  manifestly 
traced  to  one  or  the  other  drug.  We  shall  afterwards 
recur  to  the  special  cases  of  drug-diseases,  and  shall 
then  indicate  their  treatment  more  in  detail. 


Date  Due 


*  • '  r.  1. 


6  1979 


IRE 


1  Q  KU  U 


IUI 


CAT.    NO.    23    233  PRINTED    IN    U.S.A. 


Hartmann 


WB930 
H333h 

18U7 
v/.  1 


Hartmann's  theory  of  acute 
diseases 


UCI  CCM  LIBRARY 


